A Pharmacist-Led Model of Medication Management Service Integrated with Critical Illness Insurance Program Review: A Prospective Evaluation in Non–Small Cell Lung Cancer

A Pharmacist-Led Model of Medication Management Service Integrated with Critical Illness Insurance Program Review: A Prospective Evaluation in Non–Small Cell Lung Cancer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Pharmacist-Led Model of Medication Management Service Integrated with Critical Illness Insurance Program Review: A Prospective Evaluation in Non–Small Cell Lung Cancer Yin Wang, Changli He, Jing Liu, Fengjiao Kang, Hulin Wang, Xin Yao, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7605508/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Non–small cell lung cancer (NSCLC) is a leading cause of cancer incidence and mortality worldwide. Targeted therapies have improved outcomes, yet challenges remain, including poor adherence, drug-related problems (DRPs), and inadequate management of adverse events. Meanwhile, the critical illness insurance program (CIIP) alleviates financial burdens but is often misaligned with rational clinical drug use. Pharmacist-led medication management services (MMS) have shown value, but their integration with insurance review in oncology care is underexplored. Objective To establish and evaluate a pharmacist-led MMS model integrated with a CIIP review for patients with NSCLC, aiming to optimize drug use, enhance outcomes, and promote cost containment. Methods Pharmacists collaborated with CIIP reviewers to provide MMS for insured patients receiving EGFR-TKIs, ALK-TKIs, or multitarget TKIs. Clinical outcomes, DRPs, quality of life (QoL), and healthcare costs were assessed. Statistical analyses were performed via SPSS 20.0, with paired t tests and Kruskal–Wallis tests applied. Results A total of 248 patients with advanced NSCLC were enrolled. At study completion, 168 patients achieved stable disease, 6 achieved partial remission, 32 discontinued therapy, and 26 died, yielding a disease control rate of 70.16%. At baseline, 305 DRPs were identified (mean, 1.23 per patient), nearly half (49.84%) of which involved medication safety and 34.10% adherence. By the end of the study, the number of unresolved DRPs had decreased to 48 (mean, 0.25 per patient). Over one year, patients’ QoL scores improved significantly [80 (72–92) vs. 112 (93–122)]. Pharmacist involvement in MMS and CIIP reviews generated estimated savings of 2.08 million CNY in direct medical costs. Conclusions This prospective evaluation demonstrated that a pharmacist-led MMS model integrated with a CIIP review reduced DRPs, improved adherence and QoL, and enhanced disease control while achieving substantial cost savings. The findings highlight the potential of combining pharmaceutical care with insurance oversight to achieve rational drug use and financial sustainability in oncology, with important clinical and policy implications for broader adoption. medication management services insurance cost control EGFR-TKI ALK-TKI non–small cell lung cancer Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7605508","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":532971707,"identity":"7d39ed1a-fddd-497c-b1c8-f34327094ba4","order_by":0,"name":"Yin Wang","email":"","orcid":"","institution":"Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China","correspondingAuthor":false,"prefix":"","firstName":"Yin","middleName":"","lastName":"Wang","suffix":""},{"id":532971708,"identity":"23b4be0f-631e-488a-a3b6-27abbdf53755","order_by":1,"name":"Changli He","email":"","orcid":"","institution":"Sichuan 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Cancer","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"medication management services, insurance cost control, EGFR-TKI, ALK-TKI, non–small cell lung cancer","lastPublishedDoi":"10.21203/rs.3.rs-7605508/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7605508/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eNon\u0026ndash;small cell lung cancer (NSCLC) is a leading cause of cancer incidence and mortality worldwide. Targeted therapies have improved outcomes, yet challenges remain, including poor adherence, drug-related problems (DRPs), and inadequate management of adverse events. Meanwhile, the critical illness insurance program (CIIP) alleviates financial burdens but is often misaligned with rational clinical drug use. Pharmacist-led medication management services (MMS) have shown value, but their integration with insurance review in oncology care is underexplored.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo establish and evaluate a pharmacist-led MMS model integrated with a CIIP review for patients with NSCLC, aiming to optimize drug use, enhance outcomes, and promote cost containment.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003ePharmacists collaborated with CIIP reviewers to provide MMS for insured patients receiving EGFR-TKIs, ALK-TKIs, or multitarget TKIs. Clinical outcomes, DRPs, quality of life (QoL), and healthcare costs were assessed. Statistical analyses were performed via SPSS 20.0, with paired t tests and Kruskal\u0026ndash;Wallis tests applied.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 248 patients with advanced NSCLC were enrolled. At study completion, 168 patients achieved stable disease, 6 achieved partial remission, 32 discontinued therapy, and 26 died, yielding a disease control rate of 70.16%. At baseline, 305 DRPs were identified (mean, 1.23 per patient), nearly half (49.84%) of which involved medication safety and 34.10% adherence. By the end of the study, the number of unresolved DRPs had decreased to 48 (mean, 0.25 per patient). Over one year, patients\u0026rsquo; QoL scores improved significantly [80 (72\u0026ndash;92) vs. 112 (93\u0026ndash;122)]. Pharmacist involvement in MMS and CIIP reviews generated estimated savings of 2.08\u0026nbsp;million CNY in direct medical costs.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThis prospective evaluation demonstrated that a pharmacist-led MMS model integrated with a CIIP review reduced DRPs, improved adherence and QoL, and enhanced disease control while achieving substantial cost savings. The findings highlight the potential of combining pharmaceutical care with insurance oversight to achieve rational drug use and financial sustainability in oncology, with important clinical and policy implications for broader adoption.\u003c/p\u003e","manuscriptTitle":"A Pharmacist-Led Model of Medication Management Service Integrated with Critical Illness Insurance Program Review: A Prospective Evaluation in Non–Small Cell Lung Cancer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-23 14:32:54","doi":"10.21203/rs.3.rs-7605508/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f7901e8a-d585-4ebb-b5ca-32b7c3270421","owner":[],"postedDate":"October 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-21T11:41:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-23 14:32:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7605508","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7605508","identity":"rs-7605508","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}