Focus on Health System Specialty Pharmacy at ASHP Summer Meeting

The American Society of Health-System Pharmacists (ASHP) launched a Section of Specialty Pharmacy Practitioners (SSPP) last year to represent the needs of providers in large areas of practice, such as specialty pharmacy. As of May, the SSPP had approximately 4400 members, which further underscores the industry trend of health system-based specialty pharmacies and the desire for additional representation in this practice area.

At the ASHP Summer Meetings and Exhibition 2019, held June 8-12 in Boston, MA, thought-provoking sessions included reporting on clinical outcome measures, the importance of accreditation, and the need to build and maintain relationships. Notable advice for health systems building out new specialty pharmacy services included aligning your program with the mission and vision of your overall health system strategy, to incorporate yourself into the clinics, and become part of the multidisciplinary care team. The conference also featured 5-minute sessions called “Specialty Pharmacy Pearls,” which provided quick descriptions of specialty pharmacy programs covering a wide range of topics.

Two "pearls" of note are highlighted below:

Zach Russell, PharmD CSP/ExceleraRx Corp, provided recommendations around the development of key performance measures for specialty pharmacies to show their value to stakeholders. He also highlighted how standardization around key performance metrics (KPMs) can improve internal operational goals and fulfill accreditation, payer, and pharma requirements. Examples such as turnaround time, prescription abandonment and patient or provider satisfaction are important to assess regularly, as these allow for benchmarking opportunities, quality improvement and reporting to key external stakeholders.

Julie Kidd, PharmD, MPH, BCPS, CPP/Novant Health Specialty Pharmacy, presented on "Pharmacist-led Strategy for Monitoring Infusible Disease Modifying Therapies for the Treatment of [multiple sclerosis (MS)]," which described services that extended beyond oral and self-injectable medication to pharmacist-led monitoring for infusible treatments in MS. This scenario allows the pharmacist to be integrated into the clinic in a practitioner role with privileges to order labs and medications and send referrals with oversight from a physician partner. The pharmacist can also take charge of risk evaluation and management strategies (REMS) requirements as needed for patient follow-up. This model allows for more timely assessment of labs and follow-up as well as improving adherence to REMS monitoring.

“Our clinical pharmacist practitioner (CPP)—led service at Novant Health Center for Multiple Sclerosis leverages the pharmacist in a practitioner role,” Kidd explained. “This has become important to ensure required safety labs are completed by patients on infusible disease modifying therapy (DMT) and care plans are promptly created. Patients are receiving high-touch care from the CPP either face-to-face in clinic or by phone between office visits. We have eliminated gaps in patient care plans by engaging the CPP into the MS center to ensure timely and appropriate treatment with infusible DMT.”

In general, other conference topics tied to the overarching themes of health system specialty pharmacy operations, clinical outcomes and business development. Many of these tied to initiatives already underway in many health systems and discussed at other recent conferences.

Clinical Outcomes

The summer meeting stressed the importance of including clinical outcome measurements as HSSPs develop their program capabilities. Adherence measures such as proportion of days covered (PDC), hepatitis C virus cure treatment completion and cure rate, and time to progression with certain cancer therapies are some examples. It is also important for HSSPs to review pharma studies and set up programs that mimic these studies so that results and outcomes can be compared. Additionally, it is also important to use patient stories to link HSSP performance with adherence, defined end-of-treatment outcomes, and financial impacts. In addition, ongoing analytics can provide insight into prescription capture opportunities.

Business Development

The pearl session titled “The Health System SP: Clinical Pharmacist or Sales Specialist?” (Aimee M. Banks, PharmD BCPS, MSCS/Vanderbilt UMC) provided strategies to align the clinical and business aspects of the specialty pharmacist’s role to provide excellent patient care while growing the specialty pharmacy business opportunity management and conversion rates. Although optimal patient care is the priority, learning how to engage patients surrounding the types of services they could be getting at the HSSP is vital as well. Successful opportunity management includes providing patients with an understanding of the service and the goals of their care as part of a collaborative multidisciplinary team to build trust, establishing specialty pharmacy staff goals for conversion, tying results to patient satisfaction surveys, and using routine meetings to provide feedback.

Overall, the development of a specialty pharmacy track at the ASHP Summer Meeting signifies the growing importance of HSSPs as a critical component of pharmacy practice moving forward. I fully expect it will be an ongoing focus at ASHP as more health systems incorporate specialty pharmacy services and existing HSSPs find more ways to optimize outcomes and streamline their operations.

Lana Gerzenshtein PharmD, BCPS, CSP, is manager of Network Clinical Programs at ExceleraRx.