Health-System Specialty Pharmacies Becoming an Industry Cornerstone
Author: Chris Hatwig, MS, RPh, FASHP, President, Apexus and Steven Zabriski, MBA, BS Pharm, Senior Director, Payer Strategies, Acentrus Specialty
A new trend is emerging as health system–based specialty pharmacies become a staple in the industry. Physicians and pharmacists are now collaborating to improve the overall patient journey.
The consequences of providing inadequate patient care are well known and are often attributed to the fragmented nature in which care is delivered. To counter this, health systems are integrating care delivery in a more comprehensive way that allows the services they provide to be consistent and coordinated for both the patient and provider, resulting in high-quality, efficient care that better meets patients’ needs.
Specialty pharmacy plays a significant role in patient care and greatly impacts the overall patient journey. Patient access to specialty pharmacy products, if needed, completes the circle for a truly integrated health care approach.
Shifting the Focus to the Patient
At the same time that health-system specialty pharmacies are on the rise, an industrywide shift in focus is placing patients at the center of care. Consumers are being asked to play a larger role in sharing the cost burden associated with health care. This shift requires them to apply a more informed approach when making care decisions. It also will empower them to consider all options when determining where they get their care, while focusing on both cost and quality.
This trend toward consumer-driven health care accentuates the importance of optimizing the patient journey. Patients are more likely to choose settings that offer them optimum care and attention. For example: Patients who want to see a nonpreferred provider, even though the cost is higher, can now choose to take on more of the cost themselves. It’s their choice where they want to spend their money, how they want to receive their care, and from whom.
Specialty Pharmacy and the Patient Journey
Pharmacy is the most frequently used health benefit and an influential factor when patients determine their overall satisfaction with the care they have received. Specialty pharmacy therapies typically involve patients who are facing both clinical and financial challenges. As a result, compassionate, integrated care is crucial to a favorable patient experience.
Making the rest of the patient’s jour- ney as smooth as possible has to be the focus of every provider. Avoiding coverage hassles and relieving barriers to care, such as required preauthorization, help patients through this difficult time.
Optimizing the patient’s journey in this way also benefits the health system, because the care it provides extends beyond the hospital campus. As more care transitions to nonacute areas, specialty pharmacy allows the health system to maintain key patient relationships that otherwise would not exist, which results in improved continuity of care.
Specialty Pharmacy Is Critical to Seamless Care Coordination
Pharmacies are increasingly being embedded into integrated systems in which they are another source for patient data collection that already includes medical history, lab results, previous treatments, and medications. Specialty medication requires a significant investment and, because of the cost and amount of data collection necessary, it is important to maximize the return on investment for both patients and plan sponsors.
Prescribers and pharmacists working with expensive specialty drugs need to closely monitor their patients’ care and make sure they are compliant with therapy. By investing extra time in patient consulting and follow-up, specialty pharmacists can help ensure their patients are receiving higher quality care and better therapeutic outcomes and that satisfaction rises.
Professional collaboration is fast becoming an important component of the patient journey. We are rapidly moving toward a tightly integrated, collaborative approach to patient care that is more effective for the care setting and more compassionate for the patient.
Health-system specialty pharmacies allow providers and pharmacists to work together as a cohesive unit, which leads to better care management for patients. All members of the provider team have access to electronic medical records, which cover the patient’s condition and medication history. Because all these data are in 1 place, pharmacists and physicians can work with a more complete picture of a patient’s health. Systems that do not have a specialty pharmacy can experience gaps in collaboration. For example, medications can take longer to be filled, which can hamper clinical outcomes.
A Forecast for Health-System Specialty Pharmacies
This integrated, collaborative, clinical environment also benefits payers because it minimizes waste and optimizes clinical outcomes. Health systems in which the caregivers are all integrated and there is 1 unified care system for patient engagement achieve the best results in these areas.
Patients are beginning to ask for this kind of service. They want to interact with a single centralized care team rather than receive services from a variety of providers who may require multiple appointments. As this trend continues to gain momentum, more health systems are going to experience pressure from patients to adopt an integrated approach.
Why Health Care Professionals Are Excited
Health care professionals are enthusiastic about this new integrated and collaborative environment because it maximizes clinical outcomes.
Physicians are working with pharmacists as a united care team, creating a more seamless and less time-consuming process for providers and nurses. Providers who are collaborating in clinic spaces and caring for patients alongside a pharmacist are already seeing the benefits. Some health systems can put pharmacists in every specialty clinic, according to the specialty, ensuring patients receive a new level of expertise.
Pharmacists are excited because they can work with providers to make real-time changes. They don’t have to delay until their schedule allows or wait for follow-up. They can work with patients directly to reduce the time-to-fill and more directly affect medication adherence in partnership with physicians.
Why Patients Are Excited
The benefits of a collaborative physician and pharmacist relationship aren’t always immediately visible to patients. These benefits become more apparent the farther along they are on their care journey, especially when they begin their treatment. Their pharmacist becomes a part of their immediate health care team. Patients may even start to call their pharmacist directly for medical advice and answers to their questions about medications and adverse effects instead of going to their physician.
In addition to appreciating the fact that they have a larger team caring for them, patients typically are excited to have a personal relationship with their pharmacist. To many, the pharmacist becomes “their” pharmacist, because they are continually speaking and consulting with him or her.
The patient journey is changing and health-system specialty pharmacy offers providers a new way to collaborate in a more compassionate way that improves clinical outcomes for patients. The benefits for health systems are better management for patient conditions, extending patient care to nonacute settings, increased adherence, reduced time to therapy, and more efficient approaches for managing complex disease states. Soon, this level of care will be expected by every patient.