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OVERVIEW

Though non-vitamin K antagonist oral anticoagulants (NOACs) have surpassed warfarin as the treatment of choice for nonvalvular atrial fibrillation (NVAF) by both patients and clinicians, NOACs remain underutilized largely due to cost and insurance-related barriers. NOACs overcome a number of limitations associated with warfarin and demonstrate comparable, if not superior, efficacy; they exhibit fewer drug-drug interactions and patients undergo either limited or no laboratory monitoring during treatment. Recently published comparative data regarding efficacy/safety and cost, as well as the development of reversal strategies, provide much anticipated evidenced-based data to address many of the longstanding clinical uncertainties that have contributed to restrictive access. This archived broadcast, in the form of a mock P&T committee meeting, will feature 4 managed care pharmacy experts who will discuss the value of NOACs and how they may be better utilized to realize both their clinical and economic benefits.

GOAL

The goal of this activity is to provide managed care pharmacists, including pharmacy directors, with the evidence-based clinical and real-world data on NOACs compared to warfarin to use in NOAC formulary decision-making.

TARGET AUDIENCE

This activity is designed to meet the needs of managed care pharmacists, including pharmacy directors, nationwide. No prerequisites required.

LEARNING OBJECTIVES

The University of Tennessee College of Pharmacy takes responsibility for the content, quality, and scientific integrity of this CPE activity. Upon the conclusion of this activity, the participant should be able to:

• CONTRAST the benefits and risks of NOACs versus traditional warfarin therapy as demonstrated by clinical trial and real-world data.
• DIFFERENTIATE efficacy and safety of available agents in the NOAC class.
• EVALUATE varying cost implications associated with formulary decision making regarding NOACs for NVAF and other indications.

CREDIT DESIGNATION STATEMENT

The University of Tennessee College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Successful completion of this knowledge-based activity will provide a statement for 1.5 contact hours of credit (0.15 CEUs) and will be available at the completion of the activity. Successfully completing the activity and receiving credit includes: 1) participating in the session; 2) watching, listening to, and participating in the educational activity; 3) completing the self-assessment instrument  with a score of at least 70%. UAN:  0064-0000-17-220-H01-P. CE credit will be submitted to the NABP CPE Monitor within 30 days.  It is recommended that you check your NABP CPE Monitor e-profile database 30 days after the completion of any CE activity to ensure that your credits are posted.

NABP e-PROFILE ID NUMBER: Your CE credits will be submitted electronically to the NABP. Pharmacists or pharmacy technicians with questions regarding their NABP e-Profile or CPE Monitor should refer to the FAQ section on the NABP website: https://nabp.pharmacy/cpe-monitor-service/cpe-monitor-faqs/. To receive credit for your participation in this activity, all pharmacists must include their NABP e-Profile ID number, along with their month and date of birth. If incorrect information is provided, this will result in "rejected" status from the CPE Monitor. It is the responsibility of the participant to notify The University of Tennessee (within the 60 day submission timeframe) of their corrected information. Otherwise, the completed CE will not be accepted by the CPE Monitor.

Please allow up to 30 days for your credit to appear on CPE Monitor.

Type of Activity: Knowledge

Published: February 1, 2018
Expires: February 1, 2019

Media: Internet

Fee Information: There is no fee for this educational activity.

Estimated time to complete activity: 90 minutes

HOW TO EARN CREDIT

Participants must complete the activity as described above in the Credit Designation Statement. To answer the questions, click on your selected choice for each answer then proceed to the next question. We recommend that you print a copy of your answers before you submit them to us. Once completed, click on Submit Post-test at the bottom of the page. Your post-test will automatically be graded. If you successfully complete the post-test (score of 70% or higher), your statement of CE credit will be made available immediately. Click on View Certificate and print the CE statement for your records. If you receive a score lower than 70%, you will receive a message notifying you that you did not pass the post-test. You will have 2 opportunities to pass the post-test.

FULL DISCLOSURE POLICY AFFECTING CPE ACTIVITIES

As an accredited provider by the Accreditation Council for Pharmacy Education (ACPE), it is the policy of The University of Tennessee College of Pharmacy to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The Chair and Participating Faculty reported the following:

PARTICIPATING FACULTY

Sheldon J. Rich, RPh, PhD (Chair)
President - SJR Associates, LLC 
Adjunct Clinical Assistant Professor - University of Michigan
Adjunct Assistant Professor - Wayne State University
Palm Beach Gardens, FL
Dr Rich reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Paul P. Dobesh, PharmD, FCCP, BCPS
AQ Cardiology
Professor of Pharmacy Practice
College of Pharmacy
University of Nebraska Medical Center
Omaha, Nebraska
Dr Dobesh reports serving as a consultant for Boehringer Ingelheim GmbH, Daiichi-Sankyo Co Ltd, Janssen Pharmaceuticals Inc, Pfizer/BMS Alliance, and Portola Pharmaceuticals Inc.

Jeffrey D. Dunn, PharmD, MBA
Vice President, Pharmacy
Magellan Rx
Salt Lake City, Utah
Dr Dunn reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

James T. Kenney, RPh, MBA
Manager, Specialty and Pharmacy Contracts
Harvard Pilgrim Health Care
Wellesley, Massachusetts
Mr Kenney reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

OFF-LABEL PRODUCT DISCUSSION

In accordance with ACPE Criteria for Quality, the audience is advised that faculty in this CPE activity may include reference(s) to unlabeled, unapproved, or investigational uses of therapeutic agents or biomedical devices. The faculty will inform the participant of when they discuss or reference an unapproved, unlabeled, or investigational use of therapeutic agent or biomedical device.

DISCLAIMER STATEMENT

The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of The University of Tennessee College of Pharmacy name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

GRIEVANCE POLICY

A participant, sponsor, faculty member, or other individual wanting to file a grievance with respect to any aspect of an activity sponsored or cosponsored by The University of Tennessee College of Pharmacy may contact the Associate Dean for Continuing Education in writing at gfarr@utasip.com. The grievance will be reviewed and a response will be returned within 45 days of receiving the written statement. If not satisfied, an appeal to the Dean of the College of Pharmacy can be made for a second level review.

ACTIVITY

The following is an archived live broadcast designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, an archived live broadcast, and a CPE post-test, and evaluation. All 3 sections must be completed to receive CPE credit. A statement of credit will be available online immediately following successful completion of the activity.

REQUIRED COMPUTER HARDWARE/SOFTWARE

Please ensure the computer you plan to use meets the following minimum requirements:

• Operating System: Windows 98 or higher & Macintosh 2.2 or higher
• Internet Browser (Mac &/ Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher & Opera 5 or higher
• Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible.
• Peripherals: Computer speakers or headphones
• Monitor Screen Resolution: 320 x 480 or higher
• Media Viewing Requirements: Adobe Reader, Microsoft Powerpoint, Flash Player & HTML5

TABLE OF CONTENTS

Preassessment

Introduction
Sheldon J. Rich, RPh, PhD

NOACs in NVAF – Clinical Promises, Coverage Challenges, and Real-World Data
Paul P. Dobesh, PharmD, FCCP, BCPS

Mock P&T Committee Discussion
Faculty Panel

Postassessment and Evaluation

What you are about to see is a previously recorded live broadcast. Please note that only "home study" credit will be awarded for participating in this archived presentation. No "live" credits are available.