*Purpose: Post-transplant medication cost can pose a significant barrier for patient adherence and graft outcomes. Strategic selection of medication agent is often challenging and requires considerations for clinical needs, insurance coverage, and affordability. A pharmacy collaborative practice agreement (CPA) allows pharmacists to provide clinical services under supervising physicians, including therapeutic interchanges and alternative therapy recommendations. We sought to assess the impact of a pharmacy CPA on an institutional foundation’s Medication Assistance Program (MAP) funding utilization in a post-abdominal transplant ambulatory clinic.

*Methods: The institutional MAP foundation provided medication funding assistance for post-transplant recipients who met financial criteria and were unable to afford medications on the MAP formulary. MAP utilization processes routinely underwent quality review in order to conserve and prolong foundation resources. Transplant pharmacists began providing clinical services in the ambulatory clinic at Month 1. Following a multidisciplinary discussion, the MAP medication formulary was revised per clinical pharmacy recommendations, and medication approval restricted to transplant pharmacist and MAP coordinator review. A pharmacy CPA was implemented during Month 5 to allow for pharmacist prescribing following the new MAP formulary guidance and therapeutic interchanges without direct physician intervention. Changes in MAP funding utilization and prescription claim count were captured through the health-system retail pharmacy dispensing system.

*Results: Across six of the health-system retail pharmacies, the number of prescription claims processed via MAP decreased from a mean of 683 claims/month during Month 1-5 to 214 claims/month during Month 6-11 (Figure 1). Additionally, this resulted in a 51% reduction in utilization of institutional MAP funding over the course of 6 months following pharmacy CPA and revised MAP formulary implementation.

*Conclusions: Transplant clinical pharmacists practicing under a CPA reduced utilization of an institutional MAP funding, thereby producing substantial health-care system cost savings in a multidisciplinary ambulatory setting while ensuring access to evidence-based therapies.

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