Specialty Pharmacy: How Effective Teamwork Enhances the Patient Journey

Financial assistance professionals
Let’s face it, specialty pharmacy medications are expensive. Financial constraints are one of the most significant barriers to medication access and adherence. Even if a patient has insurance coverage, it does not necessarily mean that they will be able to afford the medication.

Out-of-pocket costs may arise due to a patient’s deductible or copay. Although some manufacturers may offer rebate programs and copay cards that can assist with out-of-pocket costs, patients with government-funded insurance plans, such as Medicare and Medicaid, are not eligible to participate and might need to look for other options for assistance.

Financial assistance professionals in specialty pharmacy can provide much needed service and guidance to patients who indicate financial hardship. Needs-based programs might be sponsored through the manufacturer, such as patient assistance programs, or available through other nonprofit foundations and grants.

After discussing a patient’s financial needs, the financial assistance professional can help to identify which programs the patient may be eligible for and what documentation is required. Having a hand in what can be an intimidating and arduous process, financial assistance professionals take some of this burden off of patients.

By finding ways to make medication more affordable, the patient has a better chance of starting and staying on therapy.

Nurses
In traditional nursing roles, nurses provide direct medical education to patients and year after year are rated among the most trusted professions in the United States. Their training extends beyond the prescriber’s office and hospital setting and can greatly enhance the clinical management of patients in specialty pharmacy.

In-house nursing professionals can assist in performing disease state education, administration and injection training, home infusion coordination, and conduct patient assessments regarding medication use, adverse effects, and current lab values. Field nurses can add another layer of hands-on support to patients who are grappling with complex disease states.

Whether the pharmacy provides field nurses or outsources these additional services, home visits may be required to dispense certain limited distribution medications. Field nurses can provide in-person instruction or first dose administration while also capturing a patient’s vital signs. Nurses are a trusted resource for specialty patients, lending motivation and support when faced with a disease state that seems overwhelming to manage.    
 
Pharmacists
Specialty pharmacists are trained experts in the complex drug therapy regimens dispensed by specialty pharmacy. Management of specialty disease states such as oncology, inflammatory conditions, transplant, and infectious diseases such as hepatitis C and HIV requires close involvement with patients and providers.

The specialty pharmacist fulfills a variety of duties and not only plays an important role in providing clinical expertise but can also help to make sure that all the other players are participating and communicating. Collaboration of care is vital and the pharmacist facilitates this by having direct contact with both the patient and the prescriber, as well as other team members.

Pharmacists provide drug and disease state education to patients, assess the appropriateness of therapy and the need for ongoing therapy, and perform other clinical evaluations, such as drug utilization review. Through these tasks, pharmacists are able to help patients mitigate potential adverse effects, avoid contraindications and duplications in therapy, circumvent allergic reactions and drug-drug interactions, and ensure overall patient safety.

Additionally, pharmacist-patient counseling can address adherence issues early on and set the stage for positive outcomes while championing patients’ successes.

Customer service representatives
The specialty pharmacy customer service representative is on the front lines on a daily basis. Often times, customer service representatives are the first and the last members of the care team to interact with the patient.

Customer service representatives perform an array of tasks, including onboarding of a patient, inputting allergy information and medication lists, completing clinical questionnaires with the patient or caregiver, and scheduling a patient’s order for delivery.

In addition to patient-related tasks, customer service representatives also field incoming calls from patients, prescribers, insurance companies, and other pharmacies, and triaging them to the appropriate team members. Courtesy and attention to detail are invaluable skillsets in this role and help to improve turnaround times and coordination of efforts throughout the rest of the specialty pharmacy, providing excellent service to our patients and their providers.

It Takes Teamwork to Make the Dream Work
When everyone is working together and in the best interest of the patient, the specialty pharmacy team is setting them up for success. All members of the specialty pharmacy care team should be appreciated and used for the distinctive role that they each play in supporting the patient.

In specialty pharmacy, we should emphasize the “I’s” that it takes to create a comprehensive and collaborative care team. It is with this specialization and teamwork that our specialty pharmacies evolve into much more than just a place that patients obtain medications.

Instead, we shift to a patient-centric model and with our help, patients don’t have to attempt the journey alone.
           
About the Author
Jacqueline Hanna earned her Bachelor of Science in Biological Sciences from the University of Pittsburgh before earning her Doctor of Pharmacy degree from Duquesne University in 2011. She recently received her Master of Science in Pharmacy Business Administration (MSPBA) program at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines. Jacqueline has spent the last 4 years working in Specialty Pharmacy, initially as a clinical pharmacist and most recently working on a variety of high-profile Specialty Operations Projects. In her current role, she is able to channel her passion for patient care into innovation and process design while being part of a concerted effort to transform Specialty Operations and improve the patient experience.
 



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