Abstract: SA-PO1088
Pharmacy-Led Outreach Supports Phosphate Binder Access After Dialysis Bundle Expansion
Session Information
- Kidney Replacement Therapy and Care Delivery Innovations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Martinez, Amanda J., FreseniusRx, Franklin, Tennessee, United States
- Anderson, Jeffrey D., FreseniusRx, Franklin, Tennessee, United States
- Dobbins, Michael, FreseniusRx, Franklin, Tennessee, United States
Background
On 1/1/25, phosphate binders were added to the End-Stage Renal Disease (ESRD) Prospective Payment System, shifting medication access pathways for patients with ESRD. This change introduced potential gaps in medication access and adherence. We implemented a pharmacy-led outreach program to support refill coordination and identify barriers to medication access.
Methods
We conducted a retrospective analysis of an integrated pharmacy patient outreach program from 5/27/25 to 5/1/26. Patients prescribed phosphate binders were stratified into two cohorts: (1) active patients ready to fill who had not yet refilled their medication through self-serve options, and (2) overdue patients ≥ 30 days late for refill. Overdue patients were escalated to clinical teams for further evaluation. Outcomes included contact rate, refill conversion rate, total refills facilitated, and identification of medication abundance.
Results
During the study period, the program completed 1,445,726 outreach attempts to 134,007 patients, achieving a 12.4% successful contact rate. Among successfully contacted patients, 10.2% were overdue for medication refills. Refill completion occurred in 65.8% of successful contacts, corresponding to 117,513 refills. Medication abundance, defined as patients not receiving a refill due to adequate supply on hand, was identified in 8.4% of the active patient cohort compared with 26.4% of the overdue cohort. Within the overdue cohort, medication abundance was most frequently attributed to prescription non-adherence (29.1%) and variable eating patterns (23.2%).
Conclusion
A large-scale pharmacy outreach program improved medication access following dialysis payment reform and identified medication abundance as a significant contributor to delayed refills. Escalation of persistently overdue patients to clinical teams revealed actionable opportunities to address adherence and oversupply. These findings highlight the role of integrated pharmacy services in optimizing medication management and care coordination in the evolving dialysis landscape.