A compelling parallel to BIEL’s VA formulary inclusion is the VA’s 2021 transition from metered-dose inhalers (MDIs) to dry-powder inhalers (DPIs)—a formulary shift that had wide-reaching clinical and operational impact.
Case Study: VA Formulary Transition to Fluticasone-Salmeterol DPI
Background: In July 2021, the VA replaced budesonide-formoterol MDIs (Symbicort) with fluticasone-salmeterol DPIs (Wixela Inhub) as the preferred inhaled corticosteroid/long-acting β₂-agonist therapy.
Key Outcomes:
74.9% of patients were successfully switched to the new DPI across VA facilities
14.2% of patients were later switched back due to therapeutic failure or adverse reactions
Over 91% of nonformulary consultation requests for alternative inhalers were approved, showing flexibility in clinical decision-making
Why It’s Relevant to BIEL:
Like ActiPatch and RecoveryRx, the DPI was centrally added to the VA formulary, but implemented locally
The transition demonstrated how formulary inclusion drives widespread adoption, even across diverse VA facilities
It also highlighted the importance of real-world feedback loops, which BIEL can now leverage for its PEMF devices
Case Study Insights: DPI Transition in VA Formulary
1. Formulary Inclusion Drives Scale
Over 75% of patients across VA facilities were successfully transitioned once the new DPI was placed on the formulary.
This showcases how centralized formulary decisions can trigger nationwide clinical uptake, especially in systems like the VA.
BIEL’s inclusion creates similar scale potential—one policy, system-wide impact.
2. Local Implementation Matters
While formulary inclusion was national, success depended on local providers adopting the change.
BIEL must ensure front-line clinical education, starter kits, and tech onboarding to support VA clinicians using ActiPatch and RecoveryRx.
3. Patient Feedback Enables Flexibility
14% of patients switched back due to adverse effects or lack of efficacy.
For BIEL, this reinforces the importance of real-world feedback loops: gather data, adapt positioning, and support clinical decisions with ongoing evidence.
4. Nonformulary Requests Stayed Viable
When patients or providers wanted alternative treatments, most requests were approved.
BIEL can learn from this flexibility by ensuring interoperability in care plans, so its therapies can pair with or substitute for other pain solutions.
Strategic Takeaways for BIEL
Don’t just win formulary placement—support its rollout. Clinical trainings, VA-specific guides, and targeted outreach can ensure momentum.
Build robust data channels to collect pain relief metrics, opioid reduction stats, and patient satisfaction scores.
Use feedback proactively to refine protocols and further validate efficacy.
Spotlight VA adoption as a proof point when expanding into DoD, CMS, or state Medicaid programs.
Case Study: VA Formulary Transition to Fluticasone-Salmeterol DPI
Background: In July 2021, the VA replaced budesonide-formoterol MDIs (Symbicort) with fluticasone-salmeterol DPIs (Wixela Inhub) as the preferred inhaled corticosteroid/long-acting β₂-agonist therapy.
Key Outcomes:
74.9% of patients were successfully switched to the new DPI across VA facilities
14.2% of patients were later switched back due to therapeutic failure or adverse reactions
Over 91% of nonformulary consultation requests for alternative inhalers were approved, showing flexibility in clinical decision-making
Why It’s Relevant to BIEL:
Like ActiPatch and RecoveryRx, the DPI was centrally added to the VA formulary, but implemented locally
The transition demonstrated how formulary inclusion drives widespread adoption, even across diverse VA facilities
It also highlighted the importance of real-world feedback loops, which BIEL can now leverage for its PEMF devices
Case Study Insights: DPI Transition in VA Formulary
1. Formulary Inclusion Drives Scale
Over 75% of patients across VA facilities were successfully transitioned once the new DPI was placed on the formulary.
This showcases how centralized formulary decisions can trigger nationwide clinical uptake, especially in systems like the VA.
BIEL’s inclusion creates similar scale potential—one policy, system-wide impact.
2. Local Implementation Matters
While formulary inclusion was national, success depended on local providers adopting the change.
BIEL must ensure front-line clinical education, starter kits, and tech onboarding to support VA clinicians using ActiPatch and RecoveryRx.
3. Patient Feedback Enables Flexibility
14% of patients switched back due to adverse effects or lack of efficacy.
For BIEL, this reinforces the importance of real-world feedback loops: gather data, adapt positioning, and support clinical decisions with ongoing evidence.
4. Nonformulary Requests Stayed Viable
When patients or providers wanted alternative treatments, most requests were approved.
BIEL can learn from this flexibility by ensuring interoperability in care plans, so its therapies can pair with or substitute for other pain solutions.
Strategic Takeaways for BIEL
Don’t just win formulary placement—support its rollout. Clinical trainings, VA-specific guides, and targeted outreach can ensure momentum.
Build robust data channels to collect pain relief metrics, opioid reduction stats, and patient satisfaction scores.
Use feedback proactively to refine protocols and further validate efficacy.
Spotlight VA adoption as a proof point when expanding into DoD, CMS, or state Medicaid programs.
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