A Decade of Growth: Evolution of the Neurology Complex Drugs Program at Children’s Hospital Colorado

Topic:

Other

Poster Number: 104 S

Author(s):

Tiffany Lopez, Children's Hospital Colorado, Taylor Schwab, BSN, RN, CPN, AMB-BC, Children's Hospital Colorado, Jennifer Momot, BSN, RN, CPN, Children's Hospital Colorado, Julie Parsons, MD, University of Colorado School of Medicine, Scott Demarest, MD, MSCS, Children's Hospital Colorado, Christine Caneva, MBA, Children's Hospital Colorado, Melissa Gibbons, MS, Children's Hospital Colorado, Anne Stratton, MD, Children's Hospital Colorado, Susan Apkon, Children’s Hospital Colorado, Michele Yang, MD, Children's Hospital Colorado

Objectives: To describe the decade-long evolution of the Neurology Complex Drugs Program (CDP) and the multidisciplinary structure that supports efficient care for patients receiving novel therapeutics. Additional goals include evaluating the prior authorization process and understanding how shifting payor policies, outcome measures, and regulatory requirements have shaped program operations.

Methods: A retrospective assessment examined changes in team composition, patient volume, supported diagnoses, onboarding of novel therapies, and insurance prior authorization trends since program inception.

Results: The program began with ad hoc roles on the neuromuscular team managing nusinersen treatment and expanded over nine years into a multidisciplinary team of co‑medical directors, two RN care coordinators, and an Operations Program Manager (OPM). This structure enabled the successful onboarding of 11 high‑cost therapies across five neurological diagnoses. Ongoing evaluation of metrics and workflows has significantly decreased time‑to‑treatment. Close coordination with internal teams, pharmaceutical companies, and insurance companies resulted in coverage of 1,738 of 1,740 administered treatments.

Discussion: The last decade has been exciting for the neuromuscular world. Multiple novel therapeutics are now available for disorders that, in the past, had no treatment. However, these treatments are high-cost and some are associated with potential serious adverse events. The CDP has created pathways and policies to ensure patient safety is monitored closely and there is standardization of care. The OPM has played a central role in navigating changing insurance policies and authorization requirements, minimizing institutional financial risk by securing authorization for treatments and supporting seamless scheduling. This model has been expanded at our institution to other sections under the umbrella of the Precision Medicine Institute.

Conclusion: The Neurology Complex Drugs Program has become a leading model within Children’s Hospital Colorado, demonstrating the value of a structured, multidisciplinary approach to rapidly and safely integrating new therapies, reducing operational burden, expediting treatment, and minimizing financial risk.