New oral oncology medications introduce novel difficulties for patients during the initiation of treatment. Oral oncology medications, despite being prescribed, are not obtained by patients at a rate that can reach 30%, which is considered a significant primary medication non-adherence rate. To improve cancer treatment initiation rates in health system specialty pharmacies (HSSPs), more research is crucial to ascertain the contributing factors and develop effective strategies. The goal of this research is to calculate the frequency and grounds for PMN patients' treatment with specialty oral oncology drugs in an HSSP setting. Retrospective cohort study methodology was applied across a multisite study encompassing seven HSSP locations. Patients who received oral oncology medication referrals from the affiliated specialty pharmacy's health system, generated between May 1, 2020, and July 31, 2020, were selected for the study. Data at each site, originating from pharmacy software and electronic health records, was de-identified and aggregated for analysis. A retrospective chart review, encompassing a 60-day referral timeframe, was undertaken to pinpoint final referral outcomes and the underlying causes of unmet referrals, once unfilled referrals were identified. Referral outcomes were classified into three categories: unknown fulfillment (due to the referral being redirected to another fulfillment approach or solely for benefits investigation), outcomes fulfilled by the HSSP, and outcomes that were not filled. The primary outcome for each PMN-eligible referral was the PMN, alongside secondary outcomes concerning the cause of PMN and the time to completion. The PMN rate, ultimately determined, was established by dividing the quantity of unfilled referrals by the overall number of referrals that experienced a discernible outcome regarding filling. Out of 3891 referrals, 947 qualified for PMN, displaying a median age of 65 years (interquartile range 55-73), and a near equal gender balance of 53% male and 47% female. Medicare pharmacy coverage was the predominant insurance type (48%) among these qualified patients. The top prescribed medication, based on the data, was capecitabine, with 14% of references, and prostate cancer was the most common diagnosis, accounting for 14% of the cases. Of PMN-eligible referrals, 346 (37 percent) exhibited an unclear outcome pertaining to fill completion. Medically Underserved Area In the group of 601 referrals where fill outcomes were known, 69 referrals were authentic PMN cases, leading to a final PMN rate of 11%. A significant portion (56%) of referrals were filled by the personnel of the HSSP. The patient's decision to not fill the prescription was the most frequent reason (25%, 17/69 PMN cases). Following initial referral, the median time to completion was 5 days, with an interquartile range spanning from 2 to 10 days. HSSPs play a key role in enabling patients to initiate new oral oncology medications promptly. To enhance patient-centered cancer treatment planning, a deeper exploration of patients' reasons for declining therapy is essential, necessitating further research. Dr. Crumb participated in the planning committee for Horizon CME's Nashville APPOS 2022 Conference. The University of Illinois Chicago College of Pharmacy provided funding and support for Dr. Patel's attendance at meetings and/or travel.

Niraparib, a highly selective inhibitor of poly(adenosine diphosphate-ribose) polymerase-1 and poly(adenosine diphosphate-ribose) polymerase-2, is a prescribed treatment for carefully selected patients with ovarian, fallopian tube, and primary peritoneal cancer. Patients with metastatic castration-resistant prostate cancer (mCRPC) and homologous recombination repair (HRR) gene alterations, especially those with breast cancer gene (BRCA) alterations having progressed on prior androgen signaling inhibitor therapy and taxane-based chemotherapy, found niraparib monotherapy to be both tolerable and effective, as evidenced by the phase 2 GALAHAD trial (NCT02854436). The GALAHAD study's predetermined patient-reported outcomes are the focus of this analysis. The study included eligible individuals possessing either BRCA1/2 alterations or pathogenic alterations in other HRR genes, who subsequently received niraparib, administered daily at 300 mg. Patient-reported outcomes were measured using the Functional Assessment of Cancer Therapy-Prostate and the shorter version of the Brief Pain Inventory, specifically the Brief Pain Inventory-Short Form. The mixed-effects model, applied to repeated measurements, enabled a comparison of changes from baseline. Generally, health-related quality of life (HRQoL) saw improvement in the BRCA group by the third cycle (mean change = 603; 95% confidence interval = 276-929) and remained above baseline values through the tenth cycle (mean change = 284; 95% confidence interval = -195 to 763), while the other high-risk cohort did not show an early improvement in HRQoL from baseline (mean change = -0.07; 95% confidence interval = -469 to 455) and experienced a decrease by the tenth cycle (mean change = -510; 95% confidence interval = -153 to 506). It was not possible to gauge the median time required for pain intensity and pain-related interference to worsen in either cohort. Niraparib treatment in patients with advanced metastatic castration-resistant prostate cancer (mCRPC) and BRCA gene mutations demonstrated a more pronounced and meaningful amelioration in overall health-related quality of life, pain levels, and the extent to which pain impacted daily functioning, in comparison to patients with other homologous recombination repair (HRR) gene alterations. In evaluating treatment strategies for this cohort of castrate-resistant prostate cancer (mCRPC) patients with extensive prior therapy and high-risk genomic alterations (HRR), the attainment of disease stabilization and the enhancement of health-related quality of life (HRQoL) merit careful attention. This work's financial backing came from Janssen Research & Development, LLC, and no grant number was applicable. Dr. Smith has been awarded grants and personal fees from Bayer, Amgen, Janssen, and Lilly, alongside personal fees from Astellas Pharma, Novartis, and Pfizer. Grants from Amgen, Endocyte, and Genentech have funded Dr. Sandhu's research, in addition to grants and consulting fees from AstraZeneca and Merck, and personal fees from Bristol Myers Squibb and Merck Serono. Dr. George has received compensation from various sources, including personal fees from organizations such as the American Association for Cancer Research, Axess Oncology, Capio Biosciences, Constellation Pharma, EMD Serono, Flatiron, Ipsen, Merck Sharp & Dohme, Michael J. Hennessey Association, Millennium Medical Publishing, Modra Pharma, Myovant Sciences, Inc., NCI Genitourinary, Nektar Therapeutics, Physician Education Resource, Propella TX, RevHealth, LLC, and UroGPO; grants and personal fees from Astellas Pharma, AstraZeneca, Bristol Myers Squibb, and Pfizer; personal fees and non-financial support from Bayer and UroToday; grants from Calithera and Novartis; and grants, personal fees, and non-financial support from Exelixis, Inc., Sanofi, and Janssen Pharma. Dr. Chi received grants from Janssen while the study was being conducted. He also received grant support and personal fees from AstraZeneca, Bayer, Astellas Pharma, Novartis, Pfizer, POINT Biopharma, Roche, and Sanofi. Finally, he received personal fees from Daiichi Sankyo, Merck, and Bristol Myers Squibb. In the course of this study, Dr. Saad has been a recipient of grants, personal fees, and non-financial support provided by Janssen, as well as similar support from AstraZeneca, Astellas Pharma, Pfizer, Bayer, Myovant, Sanofi, and Novartis. find more Dr. Thiery-Vuillemin has received funding, in the form of personal fees and non-financial support, from Pfizer, AstraZeneca, Janssen, Ipsen, Roche/Genentech, Merck Sharp & Dohme, and Astellas Pharma. Additionally, the doctor has also received personal fees from Sanofi, Novartis, and Bristol Myers Squibb. Dr. Olmos's work has been supported financially by AstraZeneca, Bayer, Janssen, and Pfizer, as well as personally by Clovis, Daiichi Sankyo, and Merck Sharp & Dohme. He has also received non-financial support from Astellas Pharma, F. Hoffman-LaRoche, Genentech, and Ipsen. Dr. Danila's research endeavors have been significantly aided by the research support received from the US Department of Defense, the American Society of Clinical Oncology, the Prostate Cancer Foundation, Stand Up to Cancer, Janssen Research & Development, Astellas Pharma, Medivation, Agensys, Genentech, and CreaTV. Grants from Janssen funded Dr. Gafanov's work while the study was ongoing. The study conducted by Dr. Castro benefited from Janssen grants. Dr. Castro also received grants and personal fees from Janssen, Bayer, AstraZeneca, and Pfizer, as well as personal fees from Astellas Pharma, Merck Sharp & Dohme, Roche, and Clovis. Dr. Moon's research funding comes from SeaGen, HuyaBio, Janssen, BMS, Aveo, and Xencor, and personal compensation from Axess Oncology, MJH Life Sciences, EMD Serono, and Pfizer. Dr. Joshua has received non-financial backing from Janssen and has served in advisory or consulting capacities with Neoleukin, Janssen Oncology, Ipsen, AstraZeneca, Sanofi, Noxopharm, IQvia, Pfizer, Novartis, Bristol Myers Squibb, Merck Serono, and Eisai. Dr. Joshua has received research support from Bristol Myers Squibb, Janssen Oncology, Merck Sharp & Dohme, Mayne Pharma, Roche/Genentech, Bayer, MacroGenics, Lilly, Pfizer, AstraZeneca, and Corvus Pharmaceuticals. Janssen Research & Development has Drs. Mason, Liu, Bevans, Lopez-Gitlitz, and Francis, and Mr. Espina on its payroll. greenhouse bio-test Among Dr. Mason's assets are stocks issued by Janssen. Dr. Fizazi's involvement in advisory boards and talks spans Amgen, Astellas, AstraZeneca, Bayer, Clovis, Daiichi Sankyo, Janssen, MSD, Novartis/AAA, Pfizer, and Sanofi, with honoraria accruing to his institution, the Institut Gustave Roussy; furthermore, his advisory board participation extends to Arvinas, CureVac, MacroGenics, and Orion, with personal honoraria received. The registration number for the study is NCT02854436.

Medication access concerns are common within the healthcare setting, and ambulatory clinical pharmacists are frequently engaged as the primary medication experts to address these issues.