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Episode 11: Management of High Cost Medications


 
Ray Tancredi, RPh, MBA, CSP, vice president of specialty pharmacy development at Walgreens; Cheryl Allen, BS Pharm, MBA, vice president of business development and industry relations for Diplomat Pharmacy; Nicholas Karalis, RPh, of Elwyn Pharmacy Group; Stacey Ness, PharmD, RPh, CSP, MSCS, AAHIVP, director of specialty clinical services for Managed Healthcare Associates*; and Renee Rayburg, RPh, senior director of clinical consulting at Artemetrx, discuss how to manage the high costs of specialty medications currently flooding the market.
 
Prior authorization is a utilization management tool payors can use to control spending, Rayberg said, as well as ensuring a proper diagnosis and preventing off-label use of medication. Allen explained in detail how split-fill programs can benefit payors, not only by preventing the waste of high-cost medications, but also because it means there will be more frequent live touch points to follow up with the patient. Adequately educating the patient about how a split-fill program works can also be beneficial, Ness added.
 
This split-fill strategy can also help keep medication costs at long-term care facilities down, Karalis said. In addition, nonbiased programs that do not base formulary decisions on reimbursement challenges and instead focus just on the appropriate patient care will ultimately produce the best outcomes, he concluded.     
 
*The views expressed are those of the individual alone and not of Managed Health Care Associates, Inc.  


 


Episode #1

Episode 1: What is Specialty Pharmacy?
Episode 1: What is Specialty Pharmacy?

Episode #2

Episode 2: Understanding and Exploring the Practice of Specialty Pharmacy: How is quality measured?
Episode 2: Understanding and Exploring the Practice of Specialty Pharmacy: How is quality measured?

Episode #3

Episode 3: How Do Prior Authorization and Cost Impact Patient Care?
Episode 3: How Do Prior Authorization and Cost Impact Patient Care?

Episode #4

Episode 4 - Navigating Barriers to Therapy and Reimbursement
Episode 4 - Navigating Barriers to Therapy and Reimbursement

Episode #5

Episode 6: Evaluating Specialty Pharmacy: Reliable Methods to Measure Quality
Episode 6: Evaluating Specialty Pharmacy: Reliable Methods to Measure Quality

Episode #6

Episode 5: Is There Value to Specialty Pharmacy Accreditation?
Episode 5: Is There Value to Specialty Pharmacy Accreditation?

Episode #7

Episode 7: Data Aggregation in Specialty Pharmacy
Episode 7: Data Aggregation in Specialty Pharmacy

Episode #8

Episode 8: New Products and Limited Distribution Channels
Episode 8: New Products and Limited Distribution Channels

Episode #9

Episode 9: Role of Biosimilars in the Specialty Marketplace
Episode 9: Role of Biosimilars in the Specialty Marketplace

Episode #10

Episode 10: How Do We Know Specialty Pharmacies Are Providing Good Customer Service?
Episode 10: How Do We Know Specialty Pharmacies Are Providing Good Customer Service?

Episode #11

Episode 11: Management of High Cost Medications
Episode 11: Management of High Cost Medications

Episode #12

Episode 12: Value of Specialty Pharmacy in Oncology
Episode 12: Value of Specialty Pharmacy in Oncology

Episode #13

Episode 13: Challenges of Medication Adherence in the Oncology Population
Episode 13: Challenges of Medication Adherence in the Oncology Population

Episode #14

Episode 14: Strategies to Mitigate Side Effects and Management of Comorbidities
Episode 14: Strategies to Mitigate Side Effects and Management of Comorbidities

Episode #15

Episode 15: Are High Cost Hepatitis C Medications Worth the Price Tag?
Episode 15: Are High Cost Hepatitis C Medications Worth the Price Tag?

Episode #16

Episode 16: Encouraging Medication Adherence in Hepatitis C
Episode 16: Encouraging Medication Adherence in Hepatitis C

Episode #17

Segment 17: Managing Depression: Use of Counseling to Improve Outcomes
Segment 17: Managing Depression: Use of Counseling to Improve Outcomes

Episode #18

Segment 18: Hepatitis C Virus: Achieving an SVR and Unmet Patient Needs
Segment 18: Hepatitis C Virus: Achieving an SVR and Unmet Patient Needs
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