2. UroToday Home
  3. Recent Abstracts
  4. Urologic Oncology
  5. Prostate Cancer

Effects of In-office Dispensing by Single-specialty Urology Practices on Management of Advanced Prostate Cancer

Introduction: We examine changes in the volume of patients with advanced prostate cancer and prescriptions for abiraterone and enzalutamide among urology practices with and without in-office
dispensing.

Methods: Using data from the National Council for Prescription Drug Programs, we identified in-office dispensing by single-specialty urology practices from 2011 to 2018. As the greatest growth in
implementing dispensing occurred among large groups in 2015, outcomes were measured at the practice level in 2014 (before) and 2016 (after) for dispensing and non-dispensing practices. Outcomes included the volume of men with advanced prostate cancer managed by a practice and prescriptions for abiraterone and/or enzalutamide. Using national Medicare data, generalized linear mixed models were fit to compare the practice-level ratio of each outcome (2016 relative to 2014) adjusting for regional contextual factors.

Results: In-office dispensing increased from 1% to 30% of single-specialty urology practices from 2011 to 2018, with 28 practices implementing dispensing in 2015. In 2016 compared to 2014,
adjusted changes in the volume of patients with advanced prostate cancer managed by a practice were similar between non-dispensing (0.88, 95% CI 0.81-0.94) and dispensing (0.93, 95% CI 0.76-1.09) practices (P ΒΌ .60). Prescriptions for abiraterone and/or enzalutamide increased in both non-dispensing (2.00, 95% CI 1.58-2.41) and dispensing (8.99, 95% CI 4.51-13.47) practices (P < .01).

Conclusions: In-office dispensing is increasingly common in urology practices. This emerging model is not associated with changes in patient volume but is associated with increased prescriptions for abiraterone and enzalutamide.

Lillian Y. Lai,1 Samuel R. Kaufman,1 Mary Oerline,1 Megan E. V. Caram,2,3 Avinash Maganty,1 Vahakn B. Shahinian,1,4 and Brent K. Hollenbeck1

  1. Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan
  2. Veterans Affairs Health Services Research & Development, Center for Clinical Management and Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
  3. Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
  4. Division of Nephrology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Source: Lillian Y. Lai, Samuel R. Kaufman, Mary Oerline, et al. Effects of In-office Dispensing by Single-specialty Urology Practices on Management of Advanced Prostate Cancer. Urology Practice. 2023. doi.org/10.1097/UPJ.0000000000000390.