CSP Cheat Sheet 2026

The 30 highest-yield CSP facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. What does the Controlled Substances Act (CSA) regulate? → It regulates controlled substances to prevent misuse and abuse
2. Isavuconazonium sulfate is contraindicated in which patient? → A patient with familial short QT syndrome
3. A Medicare Part D patient needs help paying for a specialty oncology drug. Which assistance option is permissible? → An independent charitable foundation grant for the disease state
4. Under the bosentan REMS, which monitoring is required every month during treatment? → Liver aminotransferases
5. After a Part D plan issues an unfavorable coverage determination, what is the first level of appeal? → Redetermination by the Part D plan
6. Under the Affordable Care Act, how long does a provider have to report and return an identified Medicare or Medicaid overpayment? → 60 days after identification
7. Which TNF inhibitor is NOT effective for Crohn's disease? → Etanercept
8. Which tool would a specialty pharmacy use at onboarding to identify patients at risk for nonadherence? → A standardized adherence risk assessment or validated questionnaire
9. What is the importance of patient-centered care in counseling? → Incorporating the patient's values into treatment decisions
10. Which adverse effect of ibrutinib warrants periodic cardiac monitoring and patient counseling? → Atrial fibrillation
11. Which of the following is a primary role of a specialty pharmacist in managing patients on oral chemotherapy? → Proactively monitoring for and managing treatment-related adverse events and adherence.
12. Bosentan for pulmonary arterial hypertension requires which monitoring due to a boxed warning? → Liver function tests and pregnancy testing
13. What is the significance of cost-effectiveness analysis in pharmacoeconomics? → It allows healthcare providers to compare the cost and benefit of treatments
14. Why is abiraterone acetate co-administered with prednisone in metastatic prostate cancer? → To reduce mineralocorticoid excess such as hypokalemia, hypertension, and fluid retention
15. Which of these is a boxed warning for tofacitinib? → Thrombosis, including pulmonary embolism
16. Which HCV regimen is contraindicated in a patient with decompensated (Child-Pugh B or C) cirrhosis? → Glecaprevir/pibrentasvir
17. Which adherence measurement method is considered most objective but is often impractical for routine specialty pharmacy use? → Directly observed therapy or drug level measurement
18. Within how many hours must a dispenser notify FDA after determining a product is illegitimate under DSCSA? → 24 hours
19. In specialty pharmacy adherence reporting, what proportion of days covered (PDC) threshold usually defines an adherent patient? → 80% or higher
20. Under the lenalidomide REMS, which pregnancy testing is required before a female of reproductive potential starts therapy? → Two negative tests, one within 10-14 days and one within 24 hours before starting
21. A Medicare Part D patient cannot afford the coinsurance for a specialty oral oncolytic. Which assistance option is legally appropriate? → Independent charitable foundation assistance
22. Olaparib is most appropriately used in which patient population? → BRCA-mutated ovarian, breast, prostate, or pancreatic cancer
23. After the initiation injections, how often is long-acting cabotegravir (Apretude) for PrEP given? → Every 2 months
24. A patient on erlotinib develops a grade 2 acneiform rash on the face and chest. What is the most appropriate management? → Oral doxycycline or minocycline plus topical corticosteroid while continuing therapy
25. USP primarily addresses which aspect of specialty pharmacy practice? → Handling hazardous drugs to protect personnel and the environment
26. What does 'days supply' accuracy on a specialty claim affect most directly? → Refill timing, adherence measures such as PDC, and audit risk from the payer
27. What is the CMS timeframe for a standard Part D coverage determination on a drug request? → 72 hours after receiving the request
28. What is the purpose of Good Manufacturing Practices (GMP) in the pharmaceutical industry? → To ensure the quality, safety, and consistency of products
29. A patient newly prescribed oral methotrexate for rheumatoid arthritis needs counseling. Which point is most critical for safety? → Take it once a week, never daily
30. Which USP chapter governs sterile compounding, including beyond-use dates and cleanroom requirements? → USP