TY - JOUR
T1 - The Xyrem® (Sodium Oxybate) Risk Evaluation and Mitigation Strategy (REMS) Program in the USA
T2 - Results From 2016 to 2017
AU - Strunc, Michael J.
AU - Black, Jed
AU - Lillaney, Prasheel
AU - Profant, Judi
AU - Mills, Sherice
AU - Bujanover, Shay
AU - Thorpy, Michael J.
N1 - Funding Information:
The authors thank all of the patients, study investigators, study staff, pharmacy staff, and nursing team for their participation in this research. Under the direction of the authors, Kirsty Nahm, MD, employee of The Curry Rockefeller Group, LLC (CRG), and Michael J. Theisen, Ph.D. and Judith Bammert Adams, PharmD, employees of Peloton Advantage, LLC, an OPEN Health company, Jazz Pharmaceuticals funded medical writing assistance and provided editorial assistance in formatting, proofreading, and copyediting, and fact checking was also provided by CRG and Peloton Advantage.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/3
Y1 - 2021/3
N2 - Background: Sodium oxybate, which is approved for the treatment of cataplexy or excessive daytime sleepiness in patients with narcolepsy, is available in the USA only through the restricted-distribution Xyrem® Risk Evaluation and Mitigation Strategy Program (Xyrem REMS Program, XRP). The XRP requires prescriber enrollment and certification, patient enrollment, and prescriber attestation of patient counseling. Sodium oxybate is dispensed only by the certified pharmacy. After pharmacist/patient counseling, sodium oxybate is shipped only to enrolled patients, with documentation of safe use. Documentation of enrollments, prescriptions, counseling, shipments, and adverse events in a central database, and risk management reporting of any suspicion of abuse, misuse, or diversion, ensure provider notification and facilitate monitoring. Objective: This analysis reports data from the XRP regarding assessment of the risks of serious adverse outcomes that may result from inappropriate prescribing, abuse, misuse, and diversion. Methods: Data collected from December 2016 to December 2017 were analyzed. Results: Prescriptions were from enrolled prescribers (n = 4524); 17,037 patients received one or more shipment of sodium oxybate. No patients were shipped sodium oxybate under more than one name/identifier or after being disenrolled; no individual patient had overlapping active prescriptions. Sodium oxybate was dispensed in 146,426 shipments containing 375,173 bottles; of those, 13 shipments (0.009%) and 26 bottles (0.007%) were lost in delivery and not recovered. Notifications regarding potential abuse (n = 31), misuse (n = 343), or diversion (n = 22) were discussed with prescribers. Most patients and prescribers were aware of the main safety risks of sodium oxybate. Conclusions: The XRP maintains controlled access to sodium oxybate; additional prescriber education on safety risks may be warranted.
AB - Background: Sodium oxybate, which is approved for the treatment of cataplexy or excessive daytime sleepiness in patients with narcolepsy, is available in the USA only through the restricted-distribution Xyrem® Risk Evaluation and Mitigation Strategy Program (Xyrem REMS Program, XRP). The XRP requires prescriber enrollment and certification, patient enrollment, and prescriber attestation of patient counseling. Sodium oxybate is dispensed only by the certified pharmacy. After pharmacist/patient counseling, sodium oxybate is shipped only to enrolled patients, with documentation of safe use. Documentation of enrollments, prescriptions, counseling, shipments, and adverse events in a central database, and risk management reporting of any suspicion of abuse, misuse, or diversion, ensure provider notification and facilitate monitoring. Objective: This analysis reports data from the XRP regarding assessment of the risks of serious adverse outcomes that may result from inappropriate prescribing, abuse, misuse, and diversion. Methods: Data collected from December 2016 to December 2017 were analyzed. Results: Prescriptions were from enrolled prescribers (n = 4524); 17,037 patients received one or more shipment of sodium oxybate. No patients were shipped sodium oxybate under more than one name/identifier or after being disenrolled; no individual patient had overlapping active prescriptions. Sodium oxybate was dispensed in 146,426 shipments containing 375,173 bottles; of those, 13 shipments (0.009%) and 26 bottles (0.007%) were lost in delivery and not recovered. Notifications regarding potential abuse (n = 31), misuse (n = 343), or diversion (n = 22) were discussed with prescribers. Most patients and prescribers were aware of the main safety risks of sodium oxybate. Conclusions: The XRP maintains controlled access to sodium oxybate; additional prescriber education on safety risks may be warranted.
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U2 - 10.1007/s40801-020-00223-6
DO - 10.1007/s40801-020-00223-6
M3 - Article
AN - SCOPUS:85099410801
SN - 2199-1154
VL - 8
SP - 15
EP - 28
JO - Drugs - Real World Outcomes
JF - Drugs - Real World Outcomes
IS - 1
ER -