I have a question regarding the dispensing of Stivarga. Do your pharmacies open the bottle if the patient needs an amount that is not a full bottle? Per manufacturer, once the bottle is open the tablets are only good for 7 weeks. I know the manufacturer will not dispense a partial bottle and it seems that the specialty pharmacies are not breaking bottles either. We are running into the issue of having a lot of wasted tablets. Just trying to see what everyone else is doing to possibly change how we dispense this. Thanks!
Our physicians will escribe with the full dose directions so that we can obtain a prior auth for that quantity/day supply and dispense a full bottle. BUT patients are instructed on the dose escalation and also given printed directions of the dose escalation when receiving the medication. We also follow up with them seven days after starting to check side effects, re-instruct, and obtain pill count.