The availability of specialty medications has increased drastically over the past five years, improving quality of life and outcomes for patients with complex conditions. However, patients across the socio-economic spectrum still struggle to access and manage these expensive, complex drugs.
Here’s one patient’s experience, told by a member of the care team at the infectious disease clinic at a regional health system:
“A woman who was 17 weeks pregnant and living with HIV showed up at our clinic recently. While we set-up her walk-in appointment, we learned that many barriers to care – including inability to afford expensive copays – had prevented her from seeing a doctor and refilling her prescriptions for over a year.”
Unfortunately, this woman’s story isn’t unusual. Patients frequently pay the greatest price from today’s predominantly fragmented approach to specialty medication management. 40 percent of prescriptions are never filled (1) and 80 percent of patients don’t take medications as prescribed (1) – leading to three unnecessary medical visits and $2,000 in increased treatment costs annually (2).
Health systems can and should take a leading role in addressing these challenges – and increasingly many are by offering their own specialty pharmacy programs. Academic institutions, regional health systems, and local hospitals alike have successfully adopted an embedded, in-clinic model that places pharmacists and pharmacy liaisons directly in specialty clinics.
This approach addressed common barriers to access and adherence by improving the patient experience in three key ways:
- High-touch, personalized interactions: Pharmacists and pharmacy liaisons see patients face-to-face in specialty clinics to explain proper medication administration, discuss side effects, and answer questions. They also help ensure patients start and stay on their prescriptions by regularly checking-in via the phone between appointments. This high-touch approach increases adherence, maximizing therapy effectiveness. For one of our customers, this model drove a 100 percent therapy completion rate for patients with Hepatitis C — 25 percent higher than other specialty pharmacies.
- Faster, more affordable access to prescriptions: Patient liaisons simplify the patient experience by managing prior authorizations with insurance companies and securing financial assistance for expensive copays. The ability to fill prescriptions in the hospital pharmacy also eliminates delays patients face when filling prescriptions through a retail or mail-order pharmacy. We have found this approach
- Coordinated, efficient care: Specialty pharmacy programs allow doctors, nurses, and pharmacists to collaborate more efficiently, leading to more streamlined patient care. Patient liaisons and pharmacists can step up to manage specialty medication workflow, like refill reminders and lab work, so doctors and nurses are free to focus on other aspects of patient care.
Thankfully, the patient highlighted above has access to a pharmacist at her health system to support her treatment and care. Here’s how the story ends:
“I first partnered with the patient’s nurse practitioner to identify the best therapy regimen and schedule her first OBGYN appointment the next week. Then, I worked with her case manager to activate emergency prescription assistance so she could get her medications that day. Before the patient left, I walked with her to the pharmacy to pick-up her prescription. She didn’t want refills shipped to her home, so I pointed out a few free places she could park when she returned. I’m pleased that her care team was able to work together to provide an excellent experience, which has led the patient to return for all of the follow-up appointments so far.”
Working with a partner can help health systems develop strategies to overcome these obstacles and accelerate their specialty pharmacy programs to provide a personalized experience, faster, more affordable access to prescriptions, and coordinated care for your patients.
Interested in learning how your health system can overcome barriers to achieve specialty pharmacy success? Watch a recording of a recent Becker’s Hospital Review Webinar to hear our Chief Solutions Officer Tony Zappa and Chief Pharmacy Officer Jerry Buller share best practices.
- AMCP IMCP 2015 adherence reports