The Impact of Specialty Medication Adherence for Health Systems

Published 10/16/2018
by Kathryn Edwards

A Focus on Specialty Medication Adherence

At many healthcare organizations, patient outcomes suffer unnecessarily because the system to encourage and support medication adherence is fragmented and poorly coordinated. The ramifications are substantial for health systems (especially those participating in at-risk contracts), leading to adverse health outcomes, greater readmission rates and ultimately, a higher cost of care.

This is especially true with specialty medication management – medications that are high cost, high complexity, and / or require a high touch approach to ensure adherence. Today, for example, a quarter of patients prescribed specialty medications are completely nonadherent. Many more patients struggle with ongoing therapy compliance and take their medicine sporadically or in a sub-optimal way. Simple process issues like turnaround times create artificial barriers to compliance. For example, it takes 14 days on average for a patient to receive their specialty medication – a process that should take 24-48 hours at most.

Contributing to that challenge is the fact that clinicians and others involved in the care of a specialty patient operate in silos with often mis-aligned incentives. This makes it difficult to manage authorizations, fill prescriptions and coordinate treatment in a way that maximizes the effectiveness of complex medication therapy. Patients often struggle to afford the ongoing cost of the therapy. And because these medications are managed in the outpatient arena, many patients never have effective or substantive interaction with a pharmacist during their specialty medication therapy. And if they do, that pharmacist is likely in a remote call center or employed by a third party – not locally engaged as part of the health system care experience.

Health Systems can and should take a leading role in solving these issues. Health systems can remove these barriers, changing the way their patients experience specialty medication therapy, while increasing the impact to their bottom line. Studies unequivocally show that when a pharmacist is involved as part of the care team for specialty conditions that therapy adherence and completion rates increase significantly, and health outcomes improve. Coupled with resources to manage follow up, financial assistance, and administrative issues, the downstream impact on patient wellbeing is well-documented.

Having this personal access to pharmacy personnel can also help patients feel less intimidated by medication therapy and ensure adherence. They can also free physicians up to provide more effective care and remove the burden of administrative effort from their support teams.

The resulting impacts on patients and health system operations are clear:

• Improved patient experience
• Better clinical outcomes
• Accelerated revenue opportunity and growth

The prevalence and ongoing need for specialty medication therapy has never been greater. Health systems can and should take control of their patients’ experience and create better outcomes – both clinically and financially.

About the Author

Brandon Newman serves as Vice President of Clinical Affairs for Trellis Rx. Brandon is responsible for the development of best-in-class ambulatory clinical programs and oversees the Trellis Rx Advance Team, the frontline team responsible for launching customers nationally and delivering outstanding clinical and operational results within a short period of time. Previously, Brandon worked at Vanderbilt University Medical Center Specialty Pharmacy where he was the Program Director and led payor and manufacturer relations.