Category: Federal Forum Posters
Purpose: Pharmacists play a valuable role in ensuring the Veterans Affairs Health Care System (VAHCS) provides clinically supported, cost-effective treatment to as many veterans as possible. This medication use evaluation assesses the prescribing patterns of glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide for type 2 diabetes management, including audits of prior authorization utilization, within the Minneapolis VAHCS (MVAHCS). Secondly, it evaluates which veterans could be appropriate candidates to convert from GLP-1 receptor agonist treatment to formulary preference sodium-glucose cotransporter-2 (SGLT2) inhibitor empagliflozin. If converted, the estimated annual cost savings potential is 2,600 dollars per patient.
Methods: This study will pull data from the VA data warehouse using Microsoft’s Structural Query Language Server programming to find all active prescriptions for liraglutide primarily for diabetes management. The following data will be collected: patient age, gender, hemoglobin A1c (HbA1c), weight, body mass index (BMI), renal function, blood pressure, initial liraglutide prescriber, other current diabetes agents, allergies and intolerances, Care Assessment Need (CAN) score, dialysis status, pregnancy and lactation status, and duration of liraglutide therapy, as well as history of cardiovascular disease, urinary issues, pancreatic disorders, and amputation. HbA1c, weight, and BMI will be assessed at the point of liraglutide initiation, the six-month reassessment, and the most currently available labs. The reviewer will evaluate for prior authorization reassessment at six months post-initiation of liraglutide and categorize HbA1c change and percentage of weight reduction. Further analysis will be performed on this data to determine prescribing practices by clinic type, characterization of veterans (such as other diabetic agents being used), and cost savings potential if veterans are candidates for conversion to empagliflozin.
Results: not applicable
Conclusion: not applicable
Meagan Gartner– PGY1 Rural Health/Ambulatory Care Pharmacy Resident, Minneapolis VA Health Care System, Minneapolis, MN