According to the Academy of Managed Care Pharmacy, specialty pharmaceuticals represent the fastest-growing sector of the pharmaceutical market in the United States, with a projected growth rate of 20% annually.1 What does this mean for community pharmacies? As specialty drugs continue to evolve, the pharmacist’s role in administering these drugs and caring for the patients who take them will also transform. Community pharmacists have the potential to offer unmatched continuity of care for patients treated with specialty therapies.
Although specialty pharmaceuticals present new opportunities for pharmacists who are looking to expand their therapeutic reach, it is also important to understand the impact it may have on their businesses. Integrating a specialty drug into a pharmacy should be done in a deliberate way that balances the needs of a patient population with therapies the pharmacy is able to manage.
With the integration of specialty medications, pharmacists must also produce quality outcomes with meaningful data for payers and reimbursement decisions. As pharmacies consider how the rapid growth of specialty pharmaceuticals may impact their business, a focus on increasing adherence and strengthening patient relationships is key.
1 Be Data-Driven
If a pharmacy wants to integrate specialty medications, they need to be ready to deliver results to patients, providers, and payers for maintenance medications treating chronic conditions. Payers and providers must be able to see the pharmacist as a partner in gathering adherence and outcomes data, which directly impacts reimbursement. Building this foundation begins and ends with the patient.
Pharmacists can start by implementing a patient management program that combines high-technology and -touch adherence programs. With a strong adherence program in place, pharmacists can analyze the unique health needs of the communities they serve, and focus on 1 disease state based on the appropriate need, as well as their clinical expertise. Coupled together, a successful patient management program that demonstrates quality outcomes and a specific disease focus will help build population data, making the pharmacist an indispensable partner to patients, providers, and payers.
2 Create a Strong Adherence Program
Because of the high cost of specialty pharmaceuticals, payers are looking to pharmacists for management and adherence monitoring data to ensure proper use of therapy. A strong adherence program is key for pharmacies, and pharmacists must look to innovations in technology to connect with patients further without creating additional labor expense.
Technology solutions, including refill reminders, prescription pickup notifications, and online refill requests, can help keep patients on their care path for the extent of their journey. Technology can support more rapid adoption and growth in medication synchronization, giving pharmacists a holistic view of each patient’s unique needs. Pharmacists can also use synchronization programs to schedule patients to pick up their medications at the same time each month. These high-technology solutions create efficiencies that give pharmacists more time to do what they do best—provide high-touch patient interaction.
Although high-technology solutions provide a solid foundation for an adherence program, high-touch programs close the gap and create critical patient engagement. Tactics including medication therapy management, motivational interviewing, and gauging patient health literacy all work to optimize drug therapy and help improve patient outcomes. When pharmacists interact with patients on a personal level, they help patients understand the need for their medication, how to properly administer the medication, mitigate side effects, and address cost barriers. High touch takes an adherence program to the next level, and creates relationships with the patients that provide extra encouragement to stay adherent.
3 Identify the Health Needs in Your Community
Another area pharmacists should consider before implementing specialty therapies is a focus on only 1 disease state. To identify where the pharmacy can make an impact, pharmacists should collect data and identify the unique health needs and disease states pertinent in the communities they serve. Then the pharmacists should evaluate where support is needed based on existing or potential patients, as well as their own clinical expertise.
For example, a pharmacy serving a large diabetic population can develop related offerings, such as nutritional counseling, shoe fittings, and group sessions to meet the immediate treatment and support needs of their patient population. Another example may be a pharmacy that has recognized the need for human immunodeficiency virus (HIV) medication adherence programs with sustained support among patients in the community. Establishing the pharmacy as a destination of support for patients with a specific disease state, such as HIV, not only builds on the trust community pharmacists are known for, but also presents an opportunity to develop a holistic care center. In this example, it is important to leverage and maintain knowledge and training on the conditions of HIV, side effects, and complex medication regimens, to increase stronger adherence programs among patients.
Pharmacists who take this approach are able to build relationships with more patients, as well as providers in their community. Community pharmacies can also use this tactic to become a partner in delivering valuable outcome data to payers, thus strengthening relationships across the continuum.
As the industry moves toward a higher prevalence of specialty drugs in pharmacies, there are key considerations community pharmacies should take into account today to position themselves as a go-to resource for providers, payers, and patients.
Pharmacists can be influential in the specialty space by creating patient management programs that have an output of meaningful and actionable data, which can be used in conversations with plans and payers to demonstrate the value of community pharmacy in the patient care continuum. Solid patient management programs, and a clear focus on 1 disease state, builds the foundation that allows the pharmacy the ability to support the business decision to offer specialty treatments.
- Specialty pharmacy: next generation specialty pharmacy [Webinar]. Academy of Managed Care Pharmacy. September 8, 2015. www.amcp.org/Tertiary.aspx?id=19280.