135 Real World Experience with Use of Coagulation Factor VIIa (Recombinant)-jncw (SevenFact®) at an Academic Medical Center

Research and Practice in Thrombosis and Haemostasis · 2025-05-01

Introduction: Eptacog beta (SevenFact®) is a recombinant factor VIIa (rVIIa) analog newly approved by the Food and Drug Administration for the prevention and treatment of bleeding in those aged 12 years or older with hemophilia A or B with inhibitors. In July 2023, our institution converted from eptacog alfa (NovoSeven®) to eptacog beta for all indications except congenital factor VII deficiency, for which eptacog beta is not recommended. The objective was to evaluate rVIIa prescribing and clinical outcomes after a formulary interchange.

Real World Experience with use of Coagulation Factor VIIa at an Academic Medical Center

Clinical and Applied Thrombosis/Hemostasis · 2025-08-01

BackgroundEptacog alfa and eptacog beta are recombinant factor VIIa (rFVIIa) agents approved for use in hemophilia A or B with inhibitors. Our institution converted from eptacog alfa to eptacog beta as the preferred rFVIIa product. The objective of this medication use evaluation was to review the utilization of both agents and cost savings associated with the conversion.MethodsWe performed a retrospective chart review for all eptacog alfa and beta administrations from October 2023 through September 2024. We evaluated product selection and dosing as well as the occurrence of thrombosis, new bleeding events, or existing bleeding that required therapy escalation. Cost savings were estimated using wholesale acquisition costs.ResultsThere were 17 patients that required 27 admissions for rFVIIa (eptacog alfa: 3, 11.1% and eptacog beta: 21, 77.8%). Three administrations (11.1%) utilized both agents. Indications included bleeding in hemophilia patients (12, 44.4%), followed by peri-procedural management (9, 33.3%), cardiac surgery (3, 11.1%), and anticoagulation reversal for life-threatening bleeding (3, 11.1%). There were 21 administrations in which eptacog beta was exclusively used (bleeding in hemophilia A (9, 33.3%), peri-procedural management (7, 25.9%), cardiac surgery (2, 7.4%), and anticoagulation reversal (3, 11.1%)). There were no thrombotic events. There were 5 patients (18.5%) who required rFVIIa dose escalation and two (7.4%) who required re-initiation of rFVIIa. Cost avoidance was estimated at $554,400 over a 12-month period.ConclusionWe treated a small cohort of patients with eptacog beta without adverse outcomes. Other hospitals might evaluate their rFVIIa use and consider opportunities for substitution.

Racial and social inequities in medication use: A review of articles responding to the <i>Journal of Managed Care</i> + <i>Specialty Pharmacy</i>’s Call to Action

Journal of Managed Care & Specialty Pharmacy · 2024-07-01 · 1 citations

Call to Action to address racial and social inequities in medication use. We find great heterogeneity in terms of topic, clinical condition examined, and health disparity addressed. Common recommendations across Viewpoint articles include the need to increase racial and ethnic diversity in clinical trial participants, the need to address drug affordability and health insurance literacy, and the need to incentivize providers and plans to participate in diversity initiatives, such as the better capture of information on social determinants of health (SDOH) in claims data to be able to address SDOH needs. Across research articles, we also find a large range of approaches and study designs, spanning from randomized controlled trials to surveys to observational studies. These articles identify disparities in which minoritized beneficiaries are shown to be less likely to receive medications and vaccines, as well as less likely to be adherent to medications, across a variety of conditions. Finally, we discuss Healthy People 2030 as a potential framework for future health disparity researchers.

COPPER(II) COMPLEXES OF NICOTINOYL AND ISONICOTINOYLHYDRAZONES: SYNTHESIS, SPECTRAL CHARACTERIZATION, AND ANTIBACTERIAL ACTIVITY

RASAYAN Journal of Chemistry · 2023-01-01

Based on physicochemical, mass, UV-visible IR, and ESR spectrum analyses, copper complexes of HANH, MBINH, and MAINH are characterized. The typical formula for the copper complexes of HANH is ML2 (where L = HANH). The tridentate HANH ligand functions as a mono-negative ligand.The typical formula for copper complexes of MBINH & MAINH is [ML2]Cl2 (M=Cu, L=MBINH & MAINH), and these ligands behave as neutral tridentate ligands.The octahedral geometry for the complexes is represented by UV-VIS spectral data. ESR spectra are used to examine the copper complexes at liquid nitrogen temperature (LNT). Redox potentials of all complexes are shifted towards + or -values in the CV data when compared with the ligands. In the current work, the antibacterial activity of ligands and metal complexes is also studied.

Implementation of an ambulatory pharmacy improvement committee across an integrated health system

American Journal of Health-System Pharmacy · 2022-03-15

Expenditures on pharmaceuticals reached $508 billion in 2019, with the majority occurring in retail (43.4%) and mail-order (25.9%) settings.1 By contrast, purchases of drugs within hospitals and clinics accounted for 7.3% and 17.8% of total prescription spending, respectively. While much has been described about coordination of pharmacy efforts among hospitals within a health system,2-5 comparatively little has been written about aligning work within such systems for drugs used in the ambulatory setting. A 2001 survey of ambulatory care pharmacists in managed care and integrated health systems discussed common responsibilities (eg, monitoring medication adherence) and features (eg, access to electronic medical records) of these settings but did not describe coordination of these efforts.6 To our knowledge, formation of an ambulatory pharmacy committee within a health system has not been described previously in the literature. With health systems increasingly including physician practices, population health management (PHM), health plans, and...

Synthesis, Spectral Characterization and Antibacterial Activity of Metal Complexes of 2-Methoxy benzaldehyde isonicotinoylhydrazone

International Journal of Science and Research (IJSR) · 2021-01-27

2-Methoxy benzaldehyde isonicotinoylhydrazone (MBINH), and its iron (II), cobalt (II) and nickel (II) complexes have been synthesized and characterized based on physico chemical properties, Electronic and IR spectra. The IR observations suggest that the ligands have coordinated through azomethine nitrogen atom, oxygen atom and through methoxy groups. The invitro antibacterial activity of complexes against Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Bacillus subtilis bacteria was screened and compared to the activity of the free ligand, the antibacterial activity of iron complex is active than Co & Ni complexes.

Opioid Prescribing After Implementation of Single Click Access to a State Prescription Drug Monitoring Program Database in a Health System’s Electronic Health Record

Pain Medicine · 2021 · 22 citations

• Computer Science
• Medicine
• Family medicine

OBJECTIVES: To determine the effect of one-click integration of a state's prescription drug monitoring program (PDMP) on the number of PDMP searches and opioid prescriptions, stratified by specialty. METHODS: Our large health system worked with the state department of public health to integrate the PDMP with the electronic health record (EHR), which enabled providers to query the data with a single click inside the EHR environment. We evaluated Schedule II or III opioid prescriptions reported to the Massachusetts PDMP 6 months before (November 15, 2017-May 15, 2018) and 6 months after (May 16, 2018, to November 16, 2018) integration. Search counts, prescriptions, patients, morphine milligram equivalents, as well as prescriber specialty were compared. RESULTS: There were 3,185 unique prescribers with a record of a Schedule II and/or III opioid prescription in both study periods that met inclusion criteria. After integration, the number of PDMP searches increased from 208,684 in the pre-integration phase to 298,478 searches in the post-integration phase (+43.0%). The number of opioid prescriptions dispensed decreased by 4.8%, the number of patients receiving a prescription decreased by 5.1%, and the mean morphine milligram equivalents (MMEs) per prescriber decreased by 5.4%. There were some notable specialty-specific differences in these measures. CONCLUSIONS: Integration of the PDMP into the EHR markedly increased the number of searches but was associated with modest decreases in opioids prescribed and patients receiving a prescription. Single click EHR integration of the PDMP, if implemented broadly, may be a way for states to significantly increase PDMP utilization.

Racial Disparities in Medication Use: <i>JMCP’s</i> Response and Call for Submissions

Journal of Managed Care & Specialty Pharmacy · 2020-10-29 · 2 citations

No funding supported the writing of this letter. The authors have nothing to disclose.

Poster Abstracts - Academy of Managed Care Pharmacy Nexus 2020

Journal of Managed Care & Specialty Pharmacy · 2020-10-01

The AMCP NEXUS 2020 VIRTUAL will be held online the week of October 19, 2020. The AMCP abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice. For NEXUS 2020 VIRTUAL, abstract posters are scheduled to be presented Wednesday, October 21, from 1:00 pm EDT to 2:30 pm EDT. At that time, poster presenters will be available for live chats and will also share additional information about their research. Professional abstracts that have been reviewed are published in the Journal of Managed Care & Specialty Pharmacy’s (JMCP) Poster Abstracts supplement.

Meeting Abstracts - AMCP 2020

Journal of Managed Care & Specialty Pharmacy · 2020 · 2 citations

• Political Science
• Computer Science
• Medical education

's Meeting Abstracts supplement.