Operational, Managerial, and Clinical Takeaways from National Association of Specialty Pharmacy Annual Meeting

This year’s National Association of Specialty Pharmacy (NASP) Annual Meeting & Expo united industry thought leaders and health care experts to discuss the future of specialty pharmacy and the patient journey. The event offers extensive information about every facet of specialty pharmacy, such as measuring its impact on patients, progression of the market, and discussions around national and legislative policy.

Members of the Shields Health Solutions team attended the 2022 meeting in Orlando, Fla. and they observed 3 key focus areas:

Practice and Operations

Jason McLaren, PharmD, JD: The NASP Annual Specialty Pharmacy Law Conference was a dynamic and informative program that addressed 2 topics of high interest in our space: private equity considerations and payer access to medications.

NASP dedicated about one-quarter of the program to the growing trend of investments in health care from the private sector, which included topics such as preparing and conducting of proper due diligence and adhering to good transaction practices. The presentations on insurance payer access provided highly impactful information given the shifting regulatory landscape for pharmacy benefit managers (PBMs) in the post-Rutledge world of increasing oversite for PBMs.

Currently, numerous states are enacting laws to reflect stricter regulations on PBMs to govern issues such as access to care and price parity.

Hospitals and Health Systems

Kayla Otterson, PharmD, CSP: The Hospital/Health Systems Specialty Pharmacy workshop covered a broad array of functions and capabilities that health-system specialty pharmacies need to ensure operational success. The conversations centered around 2 overarching themes in overcoming barriers to care: payer vertical integration and limited drug distribution networks.

Discussions emphasized that data collection, organization, and reporting are of the utmost importance in proving the value of health-system specialty pharmacies for payers and pharmaceutical manufacturers and the program shared insights on each of those elements. The program also emphasized how health system specialty pharmacy can leverage network organizations and software programs to advance collaboration and gain access to patients.

The workshop also focused on chronic disease management and population health, which include disease states outside of traditional specialty diseases, such as diabetes, hyperlipidemia, and heart failure. By applying strategies employed by integrated specialty pharmacies to those high-touch disease states, we can generate superior patient care and favorable outcomes.

The Care Coach program at UMass Memorial Health is an example of how the infrastructure of integrated specialty pharmacy can support patients with diabetes and is proven to help lower the cost of care and improve therapy adherence.

Lastly, the workshop focused on elevated standards that health-system specialty pharmacies must meet. In addition to dual accreditations that ensure the highest standard of care from specialty pharmacists, payers and manufacturers demand robust data reporting and outstanding execution proven by both clinical and financial outcomes.

Ambulatory Care

Martha Stutsky, PharmD: Several poster presentations and speaking sessions at NASP showed the importance of clinical pharmacists in ambulatory care and opportunities to expand specialty pharmacy services in ambulatory care.

For example, Dr Ana Simonyan, a clinician at Vanderbilt Specialty Pharmacy, presented a session on collective practice agreement (CPA) opportunities within specialty pharmacy. This included current published literature and some of the benefits and challenges of CPA implementation in specialty pharmacy. She identified several key focus areas for an effective CPA implementation:

• Identify stakeholder or physician champions for the CPA.
• Complete a needs assessment to determine the most valuable services to pilot with clinical services and a CPA.
• Align the incentives of the practice model with stakeholders’ values.
• Establish the infrastructure and processes to track and report relevant outcomes.

Navigating the pitfalls of prior authorization (PA) requests has proven a highly valuable resource that integrated specialty pharmacy programs can provide. The Shields Health Solutions Team, led by Dr Young Kim, demonstrated an increase of 13.2% in PA approval rates and increased appeal approvals by 22% for specialty oncology medications after the implementation of an ambulatory clinical pharmacist (ACP) remote service.

Dr Sefa Kploanyi from Shields expanded on the medication access theme in a rheumatology clinic. They achieved a 15% increase in appeal approvals and 57% decrease in prescription turnaround time after incorporating an embedded pharmacist.

Finally, Dr Mekala Paparian shared the impact of an ACP in a health-system-based multiple sclerosis clinic, showing a 37% increase in PA approvals and a 1-day decrease in turnaround time for PA requests with the enhanced ambulatory service. These increased efficiencies are critical to starting patients on their therapy as quickly as possible and simplifying the patient journey to ensure adherence.