Enhancing Patient Outcomes: The Role of Embedded Specialty Pharmacies in Biologic Access

The use of biologics in managing allergic diseases has improved patient care over the past decade, reducing the burden of atopic diseases and systemic steroid use while enhancing quality of life. Nonetheless, challenges like prior authorizations (PAs) and high medication costs continue to impact treatment decisions and patient care, leading to delays and increased administrative work.

Hospital pharmacist looking at medications | Image credit: © Ruan J/peopleimages.com | stock.adobe.com

An embedded HSSP integrates clinical pharmacists into health care settings, improving access to biologic medications. The HSSP allows clinical staff to focus on patient care by managing benefits investigations and PAs. In addition, HSSPs provide services such as patient education, medication delivery coordination, and adherence promotion, leading to better clinical outcomes.

A 2024 study presented at the American Academy of Allergy, Asthma, and Immunology Annual Meeting examined the challenges and advantages of using embedded health system specialty pharmacies (HSSPs) to manage biologic prescriptions in allergy and immunology care. The study involved providers utilizing the embedded HSSP model and was conducted at a hospital-based allergy and immunology practice from October 2022 to October 2023. Before the hospital implemented the HSSP, a team of nurses and medical assistants (MAs) managed biologic therapies at 3 locations while handling other patient care tasks, requiring staffing equivalent to 1.6 full-time employees (FTEs).

After implementing the embedded HSSP, the specialty pharmacy team managed PAs without changing the clinics’ FTEs. Providers submitted PAs through the electronic health record system and then routed them to the HSSP for processing. In case of denials, the HSSP facilitated peer-to-peer reviews and provided supporting documentation while assisting patients with accessing financial aid.

HSSPs reportedly improved the efficiency and affordability of biologics for atopic conditions. PA approval rates increased, and processing times shortened. Additionally, this model allowed nurses and MAs to focus on direct patient care, improving response times to patient messages and enhancing in-person interactions.

Finally, the study found that HSSPs minimize health costs and provide additional revenue for health systems. Federal funding programs such as the 340B Drug Pricing Program support the integration of HSSPs into hospital systems and academic center, making the HSSP model a recommended approach for optimizing the delivery of biologics in health care.

REFERENCE

Patrawala S, Mustafa SS, Ramsey A. Role of an embedded health system specialty pharmacy on prescription of biologics in allergy/immunology. Ann Allergy Asthma Immunol. 2024;133(5):602-603. doi:10.1016/j.anai.2024.07.012