Mark E. Paulson
Walgreens Specialty Pharmacy
 |
Edward Finn, RPh |
As a young pharmacy student at the
University of Pittsburgh during the mid-1980s, Edward
"Ned" Finn, RPh, had not heard of specialty pharmacy. No
one had. Just 10 years later, he had already worked as part
of a team to help develop one of the first specialty pharmacy
automated distribution centers in the United States.
Today, Finn serves as vice president of specialty operations
for Walgreens Specialty Pharmacy (WSP) and is
responsible for operations in Pittsburgh, Pennsylvania,
Ann Arbor, Michigan, Livingston, New Jersey, and Portland,
Oregon. He has spent nearly his entire career as a
pharmacist and pharmacy executive in specialty pharmacy
since graduating in 1986. His perspective spans
specialty pharmacy's past, present, and future. Below
are his responses to several questions about specialty
pharmacy.
Q: How do you define specialty pharmacy
medications?
A: Specialty medications may be manufactured
through biotech or traditional drug development
processes. In the specialty pharmacy industry, the terms
"biotech" and "specialty" are often used interchangeably. The
term specialty medication
refers to the category
as a whole, whereas
the term biotech medication
refers specifically
to those medications
created through genetic
manipulations
such as recombinant
DNA technology. As a result, use of these 2
terms varies.
Generally, these medications are expensive, with challenging
dosing regimens and high side-effect profiles.
These may be infused, injected, inhaled, or taken orally.
Most of these drugs are used to treat life-changing diseases.
Patients taking these drugs need a team approach to
support the physical, as well as the financial, psychological,
and social impact of the diseases and therapies used to
treat these conditions.
Q: How did you begin your career in
specialty pharmacy?
A: I knew I wanted to be a pharmacist before I was in
high school. The pharmacists who owned the local
independent drugstore were a big part of our community.
My plan was to buy my own drugstore and become a key
part of the community, too, and to help people. But, right
about the time I was graduating, the business of pharmacy
was changing, and the pharmacist-owned corner pharmacy
was beginning to disappear. I still wanted to work
as a retail pharmacist, so that is what I did for the first few
years of my career.
Q: How did you find your way into what became specialty pharmacy?
A: Actually, what became specialty pharmacy began as
a result of transplant operations being performed
in Pittsburgh-area hospitals starting in 1988. Patients
were coming from all over the country to have these procedures
done. When patients went back home, their local
pharmacies did not have easy access to the medications
and had little knowledge
of how to manage
transplant therapies.
Specialty
pharmacy was
born from this lack of
access, along with the
expense of these medications,
the challenges
that come from managing their administration, and coordinating the insurance
benefit.
Q: What was it about specialty pharmacy that caught your interest?
A: In 1991, I joined the local Pittsburgh pharmacy that
started a specialty pharmacy. It was really interesting.
When I started, we were working with antirejection
medications for transplant patients,
and then we began working with
HIV medications. Then, we became
one of the first companies to have
access to Crixivan, a blockbuster
medication that was the first in a
new class of cell protease inhibitors
used in the treatment of HIV.
In that first year of filling Crixivan
prescriptions, the company went
from generating revenues of $50
million per year to $300 million
per year.
With that kind of growth, I realized that specialty
pharmacy represented an incredible opportunity, and I
was offered the chance to be a part of a team tasked with
developing an automated distribution center. I have been
in specialty pharmacy every since.
Q: What do you like about working in specialty pharmacy?
A: What I like best about specialty pharmacy is being
able to help patients who have life-changing diseases,
such as oncology patients and people who have
multiple sclerosis, rheumatoid arthritis, hepatitis C, and
other chronic illnesses. The specialty medications are
expensive and can be difficult to administer, so there is
much more of a challenge to the pharmacist to help a
patient get the most from the treatment.
A lot of working with specialty pharmacy has to do with
what we all went into pharmacy for in the first place: to
help people feel better. Many of these medications have a
complicated regimen—patients have to take these medications
on a specific schedule on specific days, and it is
not always easy to keep track of what to take on which day
of the week. Also, we work with patients who had been
very self-sufficient before their disease, and now they
really need our help.
Q: What is the typical "day in the life" of a specialty pharmacist?
A: There really is no typical day for a specialty pharmacist.
It is the very nature of specialty pharmacy
that there is a lot of variety in a specialty pharmacist's
day. Much of a specialty pharmacist's day is spent on the
telephone. They will spend much of their time counseling
patients regarding their medications. Or, they may be
speaking with physicians regarding their patients and the
medications that have been prescribed for them. They
also may spend time on the phone with insurance companies,
but many of the insurance issues are resolved by
other members of the team who are experts in helping to
coordinate patient benefits. And of course, a lot of time
is spent filling and checking orders.
Education is key within a specialty pharmacy, so
specialty pharmacists also may spend part of their day
in a classroom, learning about emerging medications
and therapies. Additionally, the specialty pharmacist
will spend time at the front of the classroom, working
with nurses and patient care coordinators to keep
them informed on the latest specialty medications and
therapies.
Q: And what would you say to pharmacy students about the future of specialty pharmacy?
A: First and foremost, I would tell them that the
opportunities in specialty pharmacy are incredible,
because of the explosive growth the field is experiencing.
Ours is a growing part of the practice of medicine, and it
will not be slowing down anytime soon.
There also are tremendous opportunities in the new
technologies used in specialty pharmacy. Specialty pharmacy
is conducted in a very clinical setting, and the new
technologies we are using are found everywhere—in
dispensing the medications, in the systems that we use to
conduct and coordinate the treatments, and even in the
call centers we use to stay in touch with our patients to
make sure they are realizing the full benefit of the medications
they are taking.
But most of all, working in specialty pharmacy provides
an absolutely unique opportunity to assist patients who
truly need our help. As a specialty pharmacist, you do
much more than simply dispense medications. You are
helping people who have developed life-changing diseases
to live a better quality of life. That is what makes pharmacy
a profession and not just a job.
Inside the Issue
