NASP Leader Discusses Changing Specialty Pharmacy Landscape

In an interview with Specialty Pharmacy Times, James E. Smeeding, executive director of the National Association of Specialty Pharmacy, discusses the organization’s future and issues in the specialty marketplace.

With the recent dramatic growth of specialty drug spending, and with huge future increases projected through the rest of the decade, specialty pharmacies must prepare for an expanding marketplace.

To aid the various stakeholders in the specialty market, the National Association of Specialty Pharmacy (NASP) recently held its annual Specialty Pharmacy Expo, which ran from March 31 through April 4, 2014, at the University of South Florida’s Center for Advanced Medical Learning and Simulation in Tampa.

Specialty Pharmacy Times spoke with NASP Executive Director James E. Smeeding, RPh, MBA, about NASP’s future plans, as well as important issues and trends in specialty pharmacy.

SPT: What are the goals of NASP and what is your vision for the organization?

Smeeding: We were formed specifically to establish a professional organization for all the stakeholders in the specialty space in a collaborative manner, and we think that was the right way to do things and the right way to bring it forward. We not only have the payers, but we obviously have providers, and those are providers who are large specialty, smaller specialty, hospital specialty, pharmacy manufacturers, and other suppliers to the marketplace. We actually have patient advocacy groups, other groups such as AHIP [America’s Health Insurance Plans] and people like that all very interested in working with us and having a cross-collaborative orientation to show the value across the whole spectrum of not only products, which are very expensive as we know, but also the care that has to be taken to make it successful. So from bookend to bookend, from the initial prescription through to the patient, we have people in all of those areas of collaborative care that are working with us and that we are representing.

SPT: How does the NASP conference meet the needs of specialty pharmacies?

Smeeding: The one thing we know about the specialty space is that you have to cover all the areas that meet the needs for all of our stakeholders. Over the last 2 years, the themes that are important for our members all focus around things like patient access, the health information technology that is needed to support our goal of being able to show the positive value, the needs of the payer side of the business, as well as the accreditation side of the business. All of those areas were well represented, as well as what is going on in Washington and what options are there for patients in exchanges and under the Affordable Care Act and private insurance. Those are all the topical areas we dealt with.

The other thing that is unique is that we held the conference at the Center for Advanced Medical Learning and Simulation, which is a high-tech facility at the University of South Florida in downtown Tampa. We not only had these great classrooms and large conference rooms, but we were able to have a virtual pharmacy simulation up in the college of pharmacy space. There were separate stations all the way through the process so people could see, from intake to fulfillment, all the various aspects of care and distribution, and all the things you need to understand to be able to orient yourself toward what specialty pharmacy delivers and what tasks and domains are in the delivery of these products.

SPT: Following the NASP Expo, what do you think is in the immediate future with regard to the growth of specialty pharmacies?

Smeeding: We have launched some new initiatives, one that is all about collecting metrics to show value, which has always been a huge issue in specialty. It’s very diverse data that is usually privately held, and we felt to really show the value we need to put together a common effort that allows us to offer data to all of our collaborative members to show the value to payers, who aren’t just looking at the cost of the product, but also understanding the care that is ultimately delivered to patients. Our specialty certification board continues to enroll people who want to be certified in specialty, so that is huge. Our specialty education center now has over 200 hours of ACPE [Accreditation Council for Pharmacy Education]—approved education online, as well as some of those courses that are actually being used by colleges of pharmacy to offer credit-bearing electives to students, so that is fairly significant. Our advocacy opportunities continue to grow as more members join us, so we are advocating more in terms of the issues specialty pharmacy faces in the marketplace and gaining more corporate members as well.

We recently had a standing-room-only crowd for an educational program we had on medical marijuana, so we are the only national association in pharmacy that is standing up and saying medical marijuana needs to be managed under the guidance of pharmacists who have training and expertise in this particular area. In fact, we are helping to launch a new association called the National Association of Cannabis Pharmacists. When patients come to you asking for guidance in the use of medical marijuana for their diseases, there ought to be a good resource in pharmacy that allows patients to get the appropriate advice and direction.

SPT: Do you see the use of medical marijuana becoming more common in disease treatment?

Smeeding: Absolutely, if you take a look at what the states want out of this, they want revenue and they want control. So who is a better control mechanism than an existing, educated population of licensed caregivers to offer that type of advice? Pharmacy organizations throughout the country at the state level are saying we need to be involved in this. Some states, like Connecticut, are working through pharmacies and others are starting to think that maybe it would be a really good idea to have people who are licensed health care providers, that have storefronts, and have expertise working in that area.

SPT: What trends do specialty pharmacies need to familiarize themselves with in the coming months?

Smeeding: I think one of the big issues is data metrics to show that you are able to deliver quality. I think hospital-related opportunities in specialty are also important, as hospitals are going to get very interested in specialty and try to establish an orientation towards specialty. I think clearly that the payer viewpoint, based on what we’re seeing with hepatitis C, is going to continue to offer a lot of scrutiny with not only the cost of the product, but how it should be oriented toward that value. I think a redesign of the benefits around specialty is going to become a hotter topic and one that I think we’re going to spend a fair amount of time looking at. I think the metrics will be driven by information technology, so I think the continued evolution of information technology is going to be a critical aspect. Right now the two major issues of being a provider are access to reimbursement and access to products. So you have payers, as well as manufacturers, trying to decide how best to achieve their goals in terms of efficient delivery and effective delivery, in terms of getting good outcomes for patients, adherence, and in patient management. So I think those are all criteria that are going to be crucial for providers and for their participation in specialty pharmacy.

SPT: What do you hope are the main takeaways attendees gained from the NASP Expo?

Smeeding: The growth is explosive and the opportunities are there, but you have to be prepared and understand how to deliver the care that is demanded. The growing interest in metrics and technology is going to continue to evolve the value identification of what specialty pharmacy delivers.

SPT: For specialty pharmacies that were unable to attend NASP, what issues do they need to become familiar with moving forward?

Smeeding: I think they need to know that NASP is the lead, the original professional organization for specialty pharmacy, and there is an opportunity to connect and get the benefits out of the knowledge we can offer in terms of education and the support we can offer in terms of bringing together all the people required in terms of collaborating around the specialty pharmacy space.

SPT: What are the NASP’s immediate future plans?

Smeeding: I think NASP will establish a stronger presence throughout all of pharmacy, and also throughout medicine in general. We believe that the sub-specialty medical groups need to understand the specialty space because they’re participating in it, so I think we will see an expansion in that manner. I think we will continue to see an expansion in terms of manufacturers as they bring products to market. They will be interested in NASP as a way to have an appropriate type of discourse around their products, value, and presentation to providers. We certainly see an opportunity for international growth and we are pursuing that as we speak. We are the healthy, happy home for all the people playing into this space. We are talking to nursing organizations and specialty advocacy groups, like MS and the immune deficiency societies. People who have those types of orientation are all talking to us about the education we can bring to their patients, as well as the providers. We think there are not a lot of limiting factors stopping us from continuing to grow the organization to meet the needs of all these collaborative partner channels. So visit NASPRX.org to find out what we are doing, and you will want to belong.