How Integrated Health Care Delivery Networks Collaborate to Optimize Specialty Pharmacy Care

Given these circumstances, the importance of an integrated specialty pharmacy is thrown into sharp relief. Countless examples demonstrate the efficacy of the IDN-based approach to improve outcomes and control costs. It is very common that patients who require specialty medications must use multiple pharmacies. This presents unique challenges in managing adherence, drug–drug interactions, and overall care coordination. However, through the work of integrated health system specialty pharmacies, these issues can be addressed through read-and-write access to the patient’s electronic health record. The clinical pharmacists, from the vantage point of the pharmacy, can bring providers from multiple specialties together to coordinate the development of a care plan. This is how the care of patients with complex needs should work, and IDN-based specialty pharmacy makes the process possible.


Every health system has unique strengths and a unique culture and serves a certain geographical region, but these qualities have not served them well in accessing limited distribution drugs (LDDs). In 2012, Excelera addressed a significant barrier to drug access by completing a proprietary data reporting system that provides a single source for accurate and reliable data collection and transmission to manufacturers, who can now rely on consistent data from all health systems in the network. The data reporting provides a clear, seamless picture of what is happening at the point of care, allowing manufacturers to view health systems as viable elements of their national strategy.

For manufacturers, an advantage of the network concept is that it offers the opportunity to execute a national IDN strategy by contracting with 1 organization to access their target IDNs rather than having multiple conversations and executing contracts with multiple IDNs. With the aggregation of patients, data, and contracting, the network model creates efficiencies that make working with IDNs attractive for manufacturers.

On behalf of its members, the network can respond to manufacturer request for proposals for LDDs and be a legitimate contender. For clinical trials onward and throughout a medication’s market lifecycle, health systems in the network are an ideal home for LDDs. Specialist physicians at IDNs have access to patients to participate in clinical trials. When health systems participating in trials continue to have access to drugs even after these drugs go to market, patients are spared the problems that can result if they must begin filling their prescriptions through outside pharmacies.


For patient care, the logic of recognizing health systems as the most effective choice for specialty drug distribution is indisputable. With the collaborative power of a network behind them, health systems have the size, data, and operational capabilities to live up to manufacturer requirements.


1. Singhal, Shubham. Pharma spending growth: Making the most of our dollars. McKinsey & Company, 2017.

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