Free CSP Practice Questions

Question 1

A Medicare Part D beneficiary is prescribed an oral oncolytic with a $1,150 monthly copay. The manufacturer offers a copay assistance card that would reduce the patient's cost to $10. What is the MOST appropriate action for the specialty pharmacy?

Accepted Answer

Screen the patient for an independent charitable foundation fund covering their disease state

Answer

Apply the manufacturer copay card, since it lowers the patient's cost and supports adherence

Answer

Advise the patient to decline Part D coverage for this drug and use the card as a cash payer

Answer

Submit a formulary tier exception to the plan before exploring any outside assistance option

Question 2

A patient received a kidney transplant at a Medicare-certified facility while entitled to Medicare Part A, and is now stable on oral tacrolimus. Under which Medicare benefit are the immunosuppressants covered?

Accepted Answer

Part B, because the transplant was Medicare-covered, which extends coverage to these drugs

Answer

Part D, because tacrolimus is an oral, self-administered drug dispensed through a pharmacy

Answer

Part D, because Part B covers only drugs administered by a professional in a clinical setting

Answer

Part C, because immunosuppressant coverage is handled exclusively by Medicare Advantage plans

Question 3

A commercially insured patient has used a manufacturer copay card for their biologic since January. In July the patient is billed $2,400, and the plan confirms the deductible remains unmet despite the card having paid more than $9,000 year to date. This pattern is MOST consistent with:

Accepted Answer

A copay accumulator, which excludes third-party assistance from the deductible and OOP max

Answer

A copay maximizer, which spreads the card's full annual value evenly across the plan year

Answer

A quantity limit edit, which reduced the covered days supply and raised the per-fill share

Answer

An alternative funding program, which moved the drug outside the plan's benefit design

Question 4

A prior authorization for a JAK inhibitor is denied because the plan requires documented failure of a TNF inhibitor. The patient reports failing adalimumab two years ago under a rheumatologist in another state. What is the MOST appropriate next step?

Accepted Answer

Obtain records of the prior adalimumab trial from the former rheumatologist and resubmit

Answer

File an expedited appeal now, since delay in starting therapy could worsen disease activity

Answer

Request a peer-to-peer review, since the patient's reported history establishes necessity

Answer

Ask the prescriber for adalimumab so the patient can fail it again and satisfy the step edit

Question 5

A test claim for a biologic rejects at the pharmacy with "NDC not covered." The prescriber confirms the drug will be infused in a hospital outpatient department. What does this MOST likely indicate?

Accepted Answer

The drug is covered under the medical benefit and must be billed using a HCPCS code

Answer

The drug requires a prior authorization that the pharmacy benefit manager has not approved

Answer

The patient's pharmacy coverage has terminated and eligibility must be re-verified

Answer

The drug is non-formulary and requires a formulary exception request to the plan

Question 6

A patient with chronic hepatitis C is being started on glecaprevir/pibrentasvir. Which baseline screening addresses a BOXED WARNING associated with direct-acting antiviral therapy?

Accepted Answer

Hepatitis B surface antigen and core antibody, because HBV reactivation can occur on therapy

Answer

HLA-B*5701, because hypersensitivity has been reported with protease inhibitor regimens

Answer

Serum creatinine and eGFR, because DAA regimens are contraindicated in renal impairment

Answer

Thyroid-stimulating hormone, because DAA therapy commonly causes autoimmune thyroiditis

Question 7

All of the following are Elements to Assure Safe Use (ETASU) under a REMS EXCEPT:

Accepted Answer

A Medication Guide must be provided to the patient with each dispensed prescription

Answer

Prescribers must complete training and be specially certified before writing for the drug

Answer

Each patient must be enrolled in a registry maintained by the REMS program sponsor

Answer

The drug may be dispensed only with documented evidence of a safe-use condition

Question 8

Over a 180-day measurement period, a patient's fill history provides 198 days of medication supply because of consistent early refills. What adherence value is reported using Proportion of Days Covered (PDC)?

Accepted Answer

100%, because PDC counts only days covered within the period and is capped at 100%

Answer

110%, because PDC reflects the total days supply dispensed over the measurement period

Answer

90%, because PDC subtracts the surplus days supply carried beyond the period

Answer

80%, because PDC applies a standard adherence ceiling once the threshold is met

Question 9

A kidney transplant recipient stabilized on immediate-release tacrolimus twice daily is switched by a pharmacy to an extended-release tacrolimus product at the same total daily dose. What is the PRIMARY concern?

Accepted Answer

The formulations are not interchangeable, and the switch risks altered exposure and rejection

Answer

Extended-release tacrolimus causes more gingival hyperplasia and hirsutism than the IR form

Answer

The change voids the prior authorization and requires a new benefits investigation first

Answer

Extended-release tacrolimus must be taken with food, conflicting with the current routine

Question 10

A patient with plaque psoriasis and a documented history of Crohn's disease is prescribed secukinumab. Which concern is MOST specific to this drug class in this patient?

Accepted Answer

Interleukin-17 inhibitors may exacerbate inflammatory bowel disease and warrant caution

Answer

Interleukin-17 inhibitors carry a boxed warning for cardiovascular events and thrombosis

Answer

Interleukin-17 inhibitors require CYP2C9 genotyping before an initial dose is selected

Answer

Interleukin-17 inhibitors are absolutely contraindicated after treated latent tuberculosis

Free CSP Practice Questions

Domain 1: Safety Management Systems and Risk Assessment

Question 1

Question 2

Question 3

Question 4

Question 5

Domain 2: Advanced Safety Concepts and Emergency Preparedness

Question 6

Question 7

Question 8

Question 9

Question 10

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