Partnerships equal better patient care

Abstract

Specialty pharmacy is one of the fastest-growing areas of pharmacy. Growth is expected to be in the double digits for the next few years, and specialty is projected to be 50% of the total drug spend by 2018.1.Johnson S, Gunderson B, Bowen K, et al. Specialty drugs are forecasted to be 50 percent of all drug expenditures in 2018. http://apha.us/16reMjS. Accessed September 19, 2013.Google Scholar Because of this projected growth, pharmacists are paying increasing attention to the specialty pharmacy sector. The question being asked is not, "Should I be involved in specialty pharmacy?" but rather, "How do I gain a larger foothold in this growing market?" Community and health-system pharmacies already dispense many specialty medications for rheumatoid arthritis, Crohn disease, HIV/AIDS, and hepatitis C virus. High-level pa tient services wrapped around those and other specialty medications differentiate a specialty pharmacy. These services are usually developed in partnership with the various parties involved in the development, payment, and delivery of the medication.■Specialty pharmacy partnerships can take many forms, but the most important relationship is with the patient.■Adherence strategies that evolve out of these partnerships are the linchpin of specialty pharmacy. ■Specialty pharmacy partnerships can take many forms, but the most important relationship is with the patient.■Adherence strategies that evolve out of these partnerships are the linchpin of specialty pharmacy. Partnerships can take many forms:■Manufacturers work with specialty pharmacies before a new product release or an expansion in indications. This partnership can help solve distribution challenges, determine ancillary items required to ease administration, and develop educational processes for patients and health professionals.■Many specialty products have Risk Evaluation and Mitigation Strategies programs associated with them. Specialty pharmacies must work closely with FDA to be compliant with these programs. In addition, the accurate reporting of adverse drug events is very important to not only FDA, but the pharmaceutical partner as well.■Specialty pharmacies regularly communicate with payers to help overcome access issues for qualified patients. Specialty medications often require a prior authorization. Providing critical information on the first communication allows for a smoother prior authorization process and prevents delays in the patient starting on therapy.■Health professionals help design processes to increase efficiencies at the prescribing level and ensure patient access to specialty medications and education programs.■Specialty pharmacies establish a communication partnership with the patient that helps improve adherence. The most important relationship is with the patient using the medication. These medications can be very expensive and usually have a long list of potential adverse events associated with them. It is important that patients feel they have a trusted partner to help them navigate these barriers. Specialty pharmacies help patients by completing in-depth benefits analysis, finding financial assistance, leveraging educational programs and support groups, providing adverse event awareness and mitigation strategies, and providing adherence strategies. Implementing adherence strategies that evolve out of these partnerships are the linchpin of specialty pharmacy and the driving force behind improving patient care and satisfaction. Patients receive periodic adherence calls with specially trained pharmacists or nurses to help provide clinical oversight and educate patients on all aspects of their medication therapy. These calls typically start before patients even receive the medication, so they are prepared ahead of time on potential adverse effects, proper storage, dosing schedules, and other details specific to the medication. The initial call may include the gathering of baseline clinical data through quality-of-life surveys that can be used later by the treatment team to gauge the effectiveness of the therapy. These calls are complemented with written educational materials to help reinforce the adherence calls. The team also communicates regularly with patients' physicians to alert them to any challenges identified during these calls. This attention to detail and the improvement in adherence help drive the specialty pharmacy model. Increases in adherence rates using specialty pharmacy services have been seen in transplant, multiple sclerosis, rheumatoid arthritis, and oral oncology patients. The key to these improved adherence rates and successful partnerships is the development of educational programs around each drug and/or disease.