Agilum Releases New York State COVID-19 Drug Utilization Trends Using Real-World Data (RWD) to Help Hospitals Predict Shifting Drug Demand

^{Updated June 30, 2020}

By: Dawn DeAngelo, BS, PharmD, Chief Pharmacy Officer, Agilum Healthcare Intelligence, Inc. and
Travis J. Leonardi, RPh, C.P., CEO of Agilum Healthcare Intelligence, Inc.

In response to the rapidly evolving COVID-19 pandemic, Agilum Healthcare Intelligence analyzed real-world data (RWD) from over 29% of the hospital beds in New York state to provide hospitals and pharmacists the evidence-based data to support their ability to predict the growing demand of certain drug inventory for the treatment and supportive care for COVID-19.

Agilum’s Comparative Rapid Cycle Analytics™ platform used advanced algorithms to gain insights from its comprehensive longitudinal patient database, including trends on current drug utilization within various cohorts, to provide an understanding of the dynamic changes occurring in the drug supply chain with the evolving drug treatment protocols for COVID-19. Observations were based on:

RWD from inpatient and outpatient care, including drug dispensation data
Dynamic, real-time, continuously updated utilization trends

As the rate of COVID-19 hospital admissions slows, Agilum will sunset this study and continue to support our customers by providing real-world data and real-world evidence to help improve patient outcomes.

COVID-19 Inpatient and Outpatient Drug Utilization Review Using Real-World Data (RWD)*

Objective

By leveraging Agilum’s Comparative Rapid Cycle Analytics™ (CRCA™) platform, Agilum has focused on key drugs being utilized for COVID-19 patients to identify actual drug utilization trends by analyzing real-world data (RWD) from hospitals in the state of New York. The study methodology and criteria for review were based on the treatment of COVID-19 to demonstrate the dynamic changes occurring in the drug supply chain with the evolving drug treatment protocols.

The data tables contained herein were constructed using RWD to create an analytical approach, which seeks to add near real-time longitudinal patient data to the rapidly evolving body of knowledge pertaining to the care and treatment of patients with COVID-19.

Methodology

Examined inpatient and outpatient dispensations of select drugs from hospitals in New York state
Analyzed dispensation data from 47 hospitals representing 29% of the hospital beds in New York state
Reviewed actual data from March 1 to May 27, 2020
Targeted drugs selected due to high utilization to either treat or support COVID-19 patients
- Hydroxychloroquine/chloroquine (HCQ-CQ) tablets and the injectable forms of midazolam, fentanyl, propofol, cisatracurium and ketamine
Quantified the daily patient count and the net charge unit quantity of dispensed drugs per day for all study drugs
Estimated the percent increase/change per day to trend the change in utilization for HCQ-CQ
Modeled out the patients and drug utilization in dispensed units for the HCQ-CQ only based on the change per day. Cease HCQ-CQ modeling as the trends decrease.

NOTE: With supply chain sources fluctuating, purchases were not included in the analysis to avoid any data gaps.

Observation Summary

Drug utilization and patient trends were identified for HCQ-CQ and showed an increase in the utilization and patients mid-March, with a 20% median increase per day towards the end of the month when analyzing March 1-31, 2020 data. After March 31st, there is a flattening of the curve where the change in utilization in the beginning of April was slightly under 2% and now appears to be trending down.
The various drugs used for supportive therapy for COVID-19 are in high demand. In the NY study hospitals, the target study drugs show a shift in utilization trends towards the latter part of the month, as expected.
In the last 1-2 weeks of March, utilization patterns shifted on a daily basis for supportive medications, but there continues to be some cyclical decrease of a few of the drugs on the weekend, typically used in surgery. This would be expected because of a decrease in surgical cases on the weekend.
As these patterns are changing, the patterned utilization trends are evolving, causing the supply chain of the drugs to be greatly impacted.
Related to the drug supply chain, comments from the field indicate hospitals are now challenged with using different vial sizes to accommodate the change to the drugs being administered in higher doses or IV bags, vial sizes that they typically did not use in the past. The relevance is that, for those vial sizes that are on allocation, and/or controlled substances that have limits in place for reorder points, it becomes a challenge to order those vial sizes with controls set in place. Consideration needs to be made at a wholesaler and federal level for special considerations.

Hospitals

Representing 29% of the hospital beds in New York state

NOTE: Bed data updated and sourced from Definitive Healthcare as of April 25, 2020.