Publications by authors named "Dustin R Donald"
The landscape of therapeutic options for rare diseases is rapidly expanding, including a range of novel treatments such as antisense oligonucleotides, enzyme replacement therapies, targeted small molecules, mRNA, and gene replacement therapies. The integration of these high-cost, advanced therapeutics into clinical practice presents significant challenges. This focused review aims to outline the practical aspects of implementing non-gene therapy therapeutics that have been recently approved for rare diseases in a clinical setting, focusing on the multidisciplinary efforts required for successful integration, the coordination with various healthcare specialists, and the management of institutional and insurance-related barriers.
View Article and Find Full Text PDFPurpose: There is a growing number of specialty medications with accompanying requirements that exceed standard characteristics, which may be referred to as "ultra complex." This article details examples of ultra-complex specialty medications, including the characteristics that make them ultra complex, and strategies implemented by an integrated health-system specialty pharmacy (IHSSP) to maintain an optimal patient journey.
Summary: Before therapy initiation, ultra-complex specialty medications often require additional steps that go beyond what is required of traditional specialty treatments, such as ensuring patients have appointments scheduled and attended and coordinating medical procedures.
Background: Nearly 40% of patients do not continue proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) therapy after 6 months, despite their ability to lower low-density lipoprotein cholesterol (LDL-C) and risk of cardiovascular events. Limited work has assessed persistence to PCSK9i therapy in an integrated specialty pharmacy model.
Objective: To assess rates of persistence to PCSK9i therapy and report reasons for non-persistence in patients serviced within an integrated specialty pharmacy.