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1
Policy
For new entrants into specialty pharmacy or for those scaling their specialty pharmacy operations, staying abreast of policy changes and their potential impact is a strategic advantage as they work toward a higher maturity level, the survey results suggest.
Insights to Impact your Health System Specialty Pharmacy
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To elevate to a higher maturity specialty pharmacy, there are three prominent keys to navigating changes in the payer landscape:
1. Enhance communication by reviewing and analyzing changes to increase reimbursement
2. Reevaluate contracts using data and analytics tools for negotiation advantage
3. Collaborate with innovative partners and consulting teams at their disposal
Payer
2
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Pharmaceutical companies require large amounts of data from pharmacies to access LDDs, including compliance data, clinical data, and accreditation. These requirements vary by each specific LDD, drastically increasing the burden of reporting. Meeting pharmaceutical companies’ criteria requires a high investment of manpower, both to ensure the necessary compliance rates are met and to manage the logistics of accessing and distributing LDDs.
Pharma
3
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Data suggests that high maturity specialty pharmacies tend to be more engaged in the evolution of the specialty pharmacist’s role — driven by changes affecting reimbursement and lack of resources. Collaborative engagement with other clinicians to provide harmonious and integrated care and support optimal patient outcomes also drives revenue through differentiated offerings and patient retention.
Provider
4
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Specialty pharmacy is poised to set a new standard of care for outpatient pharmacies, and retail will follow suit with an enhanced level of care for chronic diseases and regimens. Looking into a well-defined model for high value performance (like ASHP’s HVPE) would provide a framework for growth.
Pharmacy
5
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Specialty pharmacy growth is resource-intensive, so leveraging technology and automation will be key to achieving sustainable growth. Strategic partnerships and collaboration with industry experts and advisory services offered by distributors help fill the gap.
Processes
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Expanding lines of service (infusion, home health, MID, etc.), providing equitable care, and scaling it to reach a wider demographic — are all being improved by high maturity specialty pharmacies. While these growth strategies are crucial for success, specialty pharmacies must account for administrative and workflow challenges faced by specialized team members. Exploring automation and streamlining services towards centralized dispensing and high touchpoint patient counseling is a great place to start.
Patient Care
7
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The primary outcome of receiving financial assistance is a patient’s increased adherence to their prescribed regimens, and it increases the specialty pharmacy’s ability to showcase these services and advocate for expanded access to limited distribution drugs. Accounting for patient financial savings and administrative time spent, as well as regularly communicating this to relevant stakeholders, will help specialty pharmacies in planning and budgeting.
Patient Advocacy
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