Purpose: To evaluate the utilization of national drug Criteria for Use documents for oncologic drugs in VHA.
Background: VHA National Pharmacy Benefits Management (PBM) has been developing Criteria for Use (CFU) documents for oncologic therapies since 2001. There is no formalized mechanism to track the utilization of these documents.
Methods: A sample of clinical oncology pharmacy specialists participated in an online survey of five questions regarding recollection of CFU use. A total of 23 active CFU documents were included: 11 for oral and 12 for injectable drugs. 5 questions focused on pharmacist’s recollection of the following: 1) general use of CFU documents as a reference in the past month; 2) use of particular CFU document(s) in the past month; 3) useful document(s); 4) useless document(s); and 5) specific subsections of outdated CFU that need to be updated.
Results: Nineteen pharmacists were surveyed. Responses were provided by 11 for a response rate of 58%. The majority (70%) recall using the ibrutinib CFU in the past month, followed by use of the abiraterone CFU (60%). On average, 36% recall referring to national CFU documents 3-5 times when evaluating drug orders, and 18% recall referring to them more than 5 times. The abiraterone CFU were considered to be useful by 50% of those surveyed. Both abiraterone and enzalutamide were ranked as useful documents (Q#3, n = 10) by 50%, followed by regorafenib and ibrutinib (each 40%). Aprepitant and capecitabine documents were considered to be no longer useful (Q#4, n = 6). When asked about specific areas of the CFU that are in need of update, the overwhelming majority of question responders (Q#5, n = 5) agreed that both Inclusion Criteria (100%) and Exclusion Criteria (80%) were the areas on which to focus. CFU documents for oral therapies were used more often, compared to the injectable therapies (34 vs 15%).
Implications: This pilot highlights variance in utilization and perceived usefulness of CFU documents. Expansion of this pilot with a larger sample size can help direct improvements to increase utilization.
