Webisodes

Video Transcript: Expanded Impact of Specialty Pharmacies on Pharma, Providers, Patients and Payers

Webisode transcriptions completed by third-party vendor. AmerisourceBergen Specialty Group assumes no liability for the accuracy of the content.

Gina: Specialty pharmacy relationships with prescribers. New technologies influence on physician workflow. Opportunities to increase patient engagement. How are specialty pharmacies changing the healthcare delivery process, and why should manufacturers and providers care? Join us to find out. “In the Know” starts now.
Hello and welcome to “In the Know,” your source for insight and analysis on the issues that matter to specialty pharma. I’m your host, Gina Clark.  

Today we explore how and why specialty pharmacies have grown from niche organizations to become crucial partners in the way complex and chronic diseases are treated. We’ll dive into the impact that Web-based technologies have had in creating closer ties between the pharmacies, physicians, and patients. And we’ll look at the ever-increasing role that payers play in driving the need for more efficient, standardized and measurable pharmacy operations.

Joining us today is Craig Miller, Vice President of business development for the national specialty pharmacy, US Bioservices. Thank you for being with us, Craig.

Craig: Thanks you very much, glad to be here.

So Craig, what do you see as the current role of specialty pharmacies in the care delivery process, and how does this differ from years past?

Craig: Well specialty pharmacy continues to be an important partner to the patients and providers by creating access to high cost complex therapies, and it really revolves around the patient. You know, we need to provide the education about the product; we need for them to understand how to take the product and then really work with them to manage the side effects to make sure that they’re being compliant to the medication that the physician really intended for them to take. And then one of the other burdens that’s been increasing is the financial assistance, and we work with those patients and the providers to make sure that those patients are able to access the medications. And the primary goal is just make sure that patients have the access to the therapy and they are compliant to the regiment. And specialty pharmacy should really be viewed as a resource to the practice and the patient, really to achieve better outcomes for the patient. And the big difference is, not so much the core capabilities of specialty pharmacy, it’s really more about the environment in which we work, change is constant. There are trends toward increasing prior authorization requirements, patient assistance needs, clinical pathway management. All with a need to understand and navigate the changes that are taking place with healthcare reform, which really results and has a direct impact on the demands that are being placed on the physician offices and patient access, and our role is to make life easier for them.

Gina: Have the extra demands on physicians’ and nurses’ time created a greater need for additional services from specialty pharmacies?

Craig: Absolutely. The burdens sit squarely with the physicians’ offices without our help. You know, we did a survey of 135 nurses recently at a meeting and we learned that 51% of them are spending at least an hour or more filling out filling out paperwork when a patient needs patient assistance, or even where they’re needing prior authorizations, and we also learned that many of those are spending greater than 2 hours per patient. And when we talked with the nurses, one of the things we learned is that one-third of their practices are spending an average of 26 hours or more per week just managing the prescription process. So, needless to say, the burden on the practice is tremendous, and our services are critical to the continuity of care, and as an organization we can assist with all those things to be able to help out those practices.

Gina: What other factors are contributing to the increased need for specialty pharmacy?

Craig: Gina, some of the other factors that are increasing the demand right now specialty pharmaceutical pipeline in the FDA. It’s rich, there are a lot of things that are going to be coming out, and some of those products are going to be very unique, complex in nature. Some of them will be used in combination with other products. Many of those products will be coming out in some sort of limited distribution network specialty pharmacies, possibly have a REMS associated with them or some element of safe use. In addition to that, I think there’s always a need for a compliance adherence programs that are critical to basically the operations specialty pharmacy to make sure the patients are taking the drugs appropriately. And then last, you know the cost associated with those therapies tend to have the patients need some sort of assistance that we can help out with, which is core to specialty pharmacy.

Gina: So in what ways do payers fit into this equation and how has their increased influence on care delivery affected the pharmacy market and your interaction with all of the physician’s practices.

Craig: Well, payers are a critical link and a stakeholder in this picture, and if you look at it from different perspective payers, prescribers, and the manufacturers have a common goal for the patient, which is compliance and the goal is to lead to better outcomes and subsequently lower costs. From that standpoint at the same time the payers are in the process of looking at affordability, access, appropriate use and different mechanisms to control cost and all of these things will have an impact on points of care, where the patients will be seen, distribution channels, their individual benefits and access, things that move between the pharmacy benefit and the medical benefit, and how are we coordinating that. In addition, as new products come to market, you’ll see plans to utilize more clinical guidelines as a basis for their approval of therapy. You’ll see a continuation of the utilization of prior authorizations and step edits for initiation of therapy and all this means that we need to be looking at solutions for our practices specialty pharmacy. It’s really the core, to be able to support those practices and this changing environment and as we work with payers.

Gina: So Craig, let’s talk about the role that technological innovation plays in the type of services you provide to your stakeholders. Again, let’s start with the physician practices, how has technology affected your relationship with those practices?

Craig: I believe technology is one of the most exciting advances in our industry today. It has the ability to literally transform the way we do business. And most importantly the way our customers do business with us. We’ve been very excited our new technology MyPathpoint is about creating transparency for them to see what takes place with patients when they leave the practice and go home. And it’s a tool to be specific for each practice and focuses on helping that practice. We know statistically that when prescriptions are written many of those prescriptions aren’t filled. We know that once they are filled that many of them are taken incorrectly. So this is really designed for making sure that they are in the loop with what takes place with their patient. And it’s really there to support speed of therapy, making sure that the patients are getting on drug quickly, driving compliance and adherence and above all reducing administrative burden for the practice that we just talked about. In the time and the resources that they’re having to dedicate to make sure that the patients are taken care of, it’s really about providing real time pharmacy information at their fingertips and the resources allowing the practices to choose how they want to do business with us.

Gina: What are you seeing in the way of results and where is there opportunity for future improvement?

Craig: The results are very exciting to say the least and the success of the technology is directly related to our relationship with the prescribers and their office. Once we rolled out live, we were able to speak with doctors, nurses, practice administrators, and pharmacists on how it worked for them. One of the earliest results was that we had a practice administrator call us back and say within 48 hours they were already able to achieve efficiencies and they were able to see how this was going to be very meaningful to the way that they manage their business, their practice, and moving forward. And so we’ve seen a very very strong utilization of the system once we went live. We’ve also realized that we’ve met an unmet need and the system is easy to use. So we’re looking at right now adding enhancements based on customer feedback with them in mind and current innovation around clinical support, reimbursement support and really looking at ways to integrate with other solutions that are going to be important to the practice and their future for how they manage their business.

Gina: So Craig, are there opportunities to extend these types of services and business to the patient and manufacturer markets as well?

Craig: Yeah, absolutely, it’s the same platform but just a different view. Their experience may be different based on what the customers’ needs are. For example, manufacturers want to see data that they can see and make faster decisions and understand what’s taking place. It’s also instrumental, the manufacturers are, in providing many of the materials that may be available to the patients to be able to support their type of care they need to be able to take place. So it’s really about bringing the two together in a new type of environment and the patients they are the core of our service offering. You know, there are benefits to making the patient, the provider and the specialty pharmacy all operating on the same page. So it really comes back to transparency and creating innovative solutions to support compliance for those patients.

Gina: Well that really sounds exciting, but tell me what you see as the largest challenges when it comes to engaging stakeholders with new services like these.

Craig: Well whenever you introduce new technology into the medical arena you aren’t sure how the uptake is going to be until you are there in the moment and we’ve been extremely pleased with the reception, and the biggest challenge and opportunity, I might add, is really to stay ahead of the curve for innovation and integrating it into an overall solution. And the other challenge is really sort of a good challenge to have, that is, how do we make sure that everyone knows it’s available to them and getting it out into the market place. You know, we are fortunate to have a group of individuals who have made this their passion and they’re dedicated to making sure that that takes place.

Gina: In what ways are external forces like government influence or consumer expectations changing how physician practices use technology?

Craig: Well, for one thing, it is very clear that technology is here to stay and will have a profound way on how we will do business. Government has incentives in place to help encourage technology adoption at a practice level now, so from e-prescribing to EMR’s, the carrot is out there for early adopters and the new technologies have the ability to transform and fuel growth in times that are very turbulent in healthcare right now. And then when you look at the consumers and our patients, you know, they are also resetting their expectations. There are more resources to these patients than ever before. So what we’re seeing and what our practices are seeing are patients that are walking in that are much more educated. And then when you look at the advent of social media, tweeting, face book, and other vehicles fully expecting that the consumers are pushing for different ways to interact with their service providers. So we’re being proactive in our approach and really trying to be a resource in creating different ways to be able to communicate and make sure that we’re being proactive in our approach and being in the forefront of this new technology.  

Gina: So what do you see in the near horizon for the specialty pharmacy market in terms of new services or increased responsibilities or changing relationships between them and their stakeholders?

Craig: Let’s talk about the fundamentals; you know the fundamentals of what we will do will remain the same. We are there to make sure that the patients have access to new products that come into the market place and make sure that they have access to the existing products. So we want to make sure that with those core services we are able to get patients on therapy quickly, we are able to drive compliances. You know, those two things are paramount in the management of the patient and working with our practices. New products that will be coming out will have a level of complexity and are going to be used in some cases in accommodation with other products and those will create challenges for compliance. So you’ll continue to see a lot of programs around compliance and adherence and making sure that the patients are taken care of. In addition, I think going forward we’ll be seeing more partnerships with our stakeholders to make sure that we are working with the providers and the payers in the management of pathways and really what’s going to be critical for us is being nimble in times of healthcare reform. There’s a lot of change taking place right now and making sure that we are the forefront of that. And then finally, what I was really excited about is the innovation in technology and how do we leverage that to meet our customers’ need. You know, the time’s now, it’s here. And so we have the ability to provide pharmacy and clinical services, clinical tools, compliance tools, reimbursement solutions and integrate them in one place and so needless to say we are very, very excited about our future in this space. 

Gina: Craig, this has been great! Thank you for taking the time to share your expertise.

Craig: Thank you, I appreciate the time.

Gina: And thank you for joining us, we’ll be back soon with another all new Webisode, until then if it’s on your mind, it’s In The Know.

Close Transcript