Data Analytics Help Specialty Pharmacies Personalize Health Care

The health care landscape is rapidly evolving, largely thanks to advances in genetic analysis and drug development that are paving the way for a heightened level of personalized medicine. This shift is opening doors for specialty and infusion pharmacies to handle new biologics, infusions, and other novel therapies to better serve their patients.

However, specialty pharmacies face significant logistical, financial, and operational challenges that stand in the way of patients benefiting from more personalized medicine. Specialty pharmacies must streamline their workflows by digitizing operations and leveraging advanced technologies to make new, patient-specific therapies more accessible and cost-effective.

While accounting for only 2% of prescription volume, specialty pharmacies receive more than 50% of the prescription drug spend in the US, a trend that is expected to further increase.¹

At a community impact level, specialty and infusion pharmacies are pivotal in helping patients manage complex or rare conditions. They formulate, carry, and distribute medications that often require special handling, storage, and administration instructions. These therapies hinge on clear communication between the pharmacist, the patient, their provider, and their health plan. Patient education is needed at the time of dispensing, but long before that, alignment with the provider on the recommended treatment plan and prior authorization with the health plan must be seamlessly managed.

To manage everything from prior authorizations to patient education at the point of care, followed by ongoing patient monitoring, pharmacies need to eliminate disparate, manual-first systems. This is a prerequisite for all who aspire to keep up with future drug pipeline demands and meet the momentum in the market. As an estimated 65% of new drug approvals are expected to fall into the specialty category,² now is the time to fix broken processes to deliver more personalized care experiences.

Automation Allows Clinicians to Focus on Reducing Cost to Fill and Time to Care

More than half of pharmacists feel they don’t have enough time to adequately do their job.³ Although many recognize the need to focus on patient care and education, it is often overlooked for other important tasks.

Automating administrative tasks helps carve out more time for patient-centric interactions. A software as a service-based, data-driven approach enables specialty pharmacists to streamline their operational and financial processes, significantly reducing time spent on manual tasks while maintaining accuracy by pairing human expertise with the power of technology.

This greatly increases operational efficiency for tasks like claims adjudication, prior authorization, inventory control, and revenue cycle management. Automation gives pharmacists a better ability to quickly find the correct prescriptions, fill them, and get them into the hands of patients, which is especially valuable for time-sensitive and complex treatments.

Additionally, automation helps specialty and infusion pharmacies manage the complexities of juggling educational resources, technology, and patient data to manage and create compound drugs for rapid, accurate deployment. It supports pharmacists in increasing efficacy and efficiency with automatic dosing concentrations and volumes.

The transformative impact of automation can be taken a step further with real-time, historical patient data. This is the next gear in driving operational and financial efficiency for specialty and infusion pharmacies. To ensure optimal, personalized patient care, pharmacies must establish a holistic overview of patients’ health journey.

Data that is locked away in disparate channels must be connected to better inform the pharmacist-patient interaction and care decisions around advanced therapies. This allows pharmacists to access important information about the patient, such as allergies, medical history, other conditions, and more, which could be lifesaving at the point of care.

For patients, this level of data integration—applied at the point of care to access a holistic patient profile—helps ensure they receive the right medication at the right time, improving their overall treatment efficacy and care experience.

Optimizing Site of Care Management to Improve Patient Satisfaction and the Pharmacist Experience

Filling a prescription is becoming increasingly more complex, as are where prescriptions are distributed and where patient care is administered. As the specialty and home infusion markets continue to grow and expand to new care settings, pharmacies are challenged to deliver cost-effective treatments at a faster rate, with a greater patient focus.

Automation and data connectivity can support faster, more personalized care, but to truly treat patients on a case-by-case basis, specialty pharmacies must optimize the site of care by finding the ideal setting for patients. Analyzing patient data, treatment requirements, and expected costs can give pharmacists patient-specific insights to determine the most effective and affordable treatment options. Patients can then choose their preference from the options presented, giving them a say in their care and improving their experience during what is often a challenging time, considering the nature of conditions typically managed by this type of therapy.

About the Author

Ernie Shopes is President and General Manager of Pharmacy at Inovalon.

Among all the shifts in the specialty and infusion pharmacy landscape, one thing is clear: those who embrace a technology-first approach are leading the way. Innovative pharmacies are improving operational efficiency, decreasing time and cost to fill, and enhancing the patient experience—all by leveraging the power of automation and connected patient data.

Advanced analytics will continue to make health care more accessible and empower pharmacists with the ability to personalize treatments for more effective care plans, better outcomes, and less financial strain on patients, pharmacies, and health plans.