Enhancing Patient Outcomes: The Role of Integrated Health System Specialty Pharmacies

The patient is at the heart of every health care service, and this is especially true in the delivery of specialty medications designed to improve outcomes for patients with complex conditions. However, the effectiveness of a specialty drug relies on patients starting and maintaining treatment. That is where patient engagement strategies in integrated health system specialty pharmacies can support adherence and better outcomes, benefiting the broader health system.

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The Role of Integrated Health System Specialty Pharmacies

A growing body of literature shows that health system specialty pharmacies are associated with improved medication access and adherence. A recent Journal of Managed Care and Specialty Pharmacy study demonstrated an association between health system specialty pharmacy and improved health care costs, utilization, and improvement in clinical outcomes. The results suggest that health system specialty pharmacies may have a broader role in care coordination and streamlining specialty medication management.¹

Addressing the complexity of specialty medications, patient onboarding, prior authorizations, financial assistance, and adverse effect (AE) management are core competencies of health system specialty pharmacies. Throughout the patient’s journey, addressing the following questions can support their engagement:

• Does the patient have concerns about cost that might prevent them from taking the medication properly? Streamlining prior authorization and approval processes, specialty pharmacies help patients navigate medication access to prevent financial challenges and avoid treatment delays that can impact outcomes. The pharmacy also spearheads financial initiatives to secure patient cost reductions, which may include manufacturer patient assistance programs, foundation and grant support, or health system–developed patient financial assistance programs.
• Does the patient understand why the medication is needed? Is the patient committed to the treatment regimen? Pharmacists play a significant role in helping patients understand why their medications are necessary and cultivating patient engagement by considering patient preferences for treatment and which regimen works best for them.
• Does the patient have concerns about safety or complications associated with taking the medication? Pharmacists are trained to understand patient concerns about safety and complications. Pharmacists empower patients to discuss formulation concerns, understand complicated treatment regimens, help monitor and manage AEs, and increase medication adherence to stay on treatment to improve outcomes.

Patient Engagement Strategies

With touchpoints throughout the patient’s journey, ranging from scheduling, refill reminders, shipment confirmations, and coordination between care teams, specialty pharmacies in health systems deliver high-touch support to address key access, affordability, and adherence barriers. Leveraging various channels (eg, in person, telephone calls, digital channels, health system portals), specialty pharmacies in health systems provide education, treatment monitoring, and AE management to help patients get the proper medication at the right time to get the best care. The benefits of this patient-centric approach are as follows:

• Getting patients started on treatment faster
• Improving medication adherence by addressing barriers
• Increasing patient satisfaction and outcomes

Interdisciplinary Collaboration

Beyond the walls of the specialty pharmacy, integrated pharmacists can also play an active role in coordinating critical elements of care with members of the multidisciplinary team of health care professionals. Although health care practices retain primary responsibility for patient care, specialty pharmacies can help manage clinical complexities, such as educating patients on how to take their medications properly.

Results from a recent study in American Journal of Health-System Pharmacy confirm that integrated specialty pharmacists within health systems health care can support provider satisfaction in 4 key areas: streamlining clinic workflow and/or reducing provider burden, increasing medication access, improving communication, and enhancing patient care. Ninety-five percent of providers agreed that the integrated specialty pharmacy saves time for clinic staff and that communication with patients and clinic staff during the medication access process and throughout treatment can help maintain patient engagement and improve patient and provider satisfaction.²

Specialty Pharmacies Help Health Systems Grow

As specialty pharmacies focus on proactive patient support, many strategies that generate patient satisfaction and engagement also benefit the health system. These include improving patient care and retention and reducing readmissions or emergency department visits, which results in operational and financial benefits.

With health systems experiencing downward pressure on reimbursement and margins, specialty pharmacy represents a critical new and rapidly growing source of revenue that can help offset financial challenges across the network. According to in-depth interviews McKesson recently conducted with health system specialty pharmacy leaders, the ability of the pharmacy to keep the patient within the ecosystem—to capture and dispense prescriptions for the patients they serve—is vital to the successful operation of a health system.

Conclusion

Patient engagement is critical in specialty care. Integrated specialty pharmacists within health system practices are uniquely positioned to help deliver patient engagement with high-touch support and strategies throughout the patient’s care journey. This ensures that patients have access to the treatments they need and maintain treatment, results in better provider satisfaction, and helps support financial benefits for the health system.

REFERENCES

1. Hellems SS, Soni A, Fasching D, Smith BS, McManus DD. Association between health system specialty pharmacy use and health care costs among national sample of Medicare Advantage beneficiaries. J Manag Care Spec Pharm. 2022;28(2):244-254. doi:10.18553/jmcp.2022.28.2.244

2. Anguiano RH, Zuckerman AD, Hall E, et al. Comparison of provider satisfaction with specialty pharmacy services in integrated health-system and external practice models: a multisite survey. Am J Health Syst Pharm. 2021;78(11):962-971. doi:10.1093/ajhp/zxab079