Specialty Pharmacy Gets Local

Specialty pharmacy has come a long way, starting with deep community roots. Those deep roots are part of the new trends in expanding specialty to the retail setting, which beings high-tech service and total commitment to patient well-being back to the community.

Specialty Pharmacy Times is leading the charge together with the National Association of Chain Drug Stores at its Pharmacy and Technology Conference to present a program on specialty pharmacy. By the time you read this note, Amber Pharmacy and Navarro Discount Pharmacy and I will have presented a program on local options for specialty pharmacy services. (This issue’s cover story features a 3-part article series based on this program.) Many drugstore chains are jumping onto the specialty pharmacy train, realizing the ever-growing shift from traditional pharmacy products to specialty.

Specialty pharmacy started with deep community roots and several players in the United States are taking us back to those roots. Not to take anything away from our brethren that run their specialty pharmacy business from central locations, but the local community pharmacists will say that health care is a relationship business—and few things are better than a face-to-face relationship with a patient. Specialty pharmacists will tell you that the practice requires a great deal of hand-holding, compassion, and caring. For the specialty pharmacy industry to continue to thrive, our businesses must be equally driven by both drug and service-related components.

As Phil Hagerman, RPh, of Diplomat Specialty Pharmacy notes, these 2 components need to be tied to outcomes at a level we have either been unable, or unwilling, to reach in the past. How can we become better partners to our stakeholders while improving services to our patients and always looking to enhance outcomes? Drug distribution and services must be defined, separated, and developed so that specialty pharmacies can be better partners.

The models that we are seeing at community-based specialty often include having a dedicated multi-disciplinary specialty team consisting of a clinical pharmacist, case manager, care coordinator, contract manager, and sales team. The care coordination focuses on the initial patient assessment, insurance verification, and prior authorization, copay assistance program, delivery of product, adherence, side effect management, and patient outcomes. As outlined by Albert Garcia, RPh, MHL, of Navarro Discount Pharmacies, the community specialty pharmacy team’s goal is to make sure each patient is:

• Contacted, and coordination of benefits is documented and processed
• Coordination of shipment/delivery of products is achieved
• Offered drug therapy management counseling
• Provided patient education about adverse reactions
• Given overall clinical monitoring
• Educated about ways to increase adherence
• Provided a drug utilization review

The specialty pharmacy business must be built around "improving the patients’ lives." The staff should work to ensure that every new patient receives their medication, even if restricted because of insurance or manufacturer programs. According to Albert, success has told us that it’s important to establish a local and national presence, increasing penetration and market share therapies by using service representatives, through the hiring of experienced specialty representatives.

While we have come a long way, we see significant trends in returning to our father’s pharmacy, as Phil says. However, what remains the same is that we still touch patients’ lives on a regular basis and have an incredible impact on their health and well-being. If this type of unfailing commitment to the well-being of the patient doesn’t top your list of priorities, then specialty pharmacy may not be your calling. When it comes to health care, as pharmacists and businesses, we are still the most frequent access point to this day—drugstores are on every corner, it seems, these days.

Mr. Steiber is a principal of D2 Pharma Consulting LLC (d2rx.com) and is responsible for commercial operations, tradesupply chain strategy development including 3PL selection, regulatory oversight, and “operationalizing” organizations. Mr. Steiber has served in several senior positions in pharmacy, distribution, and industry over the course of his 35-year career. He is a licensed pharmacist in Texas, Washington, California, and Pennsylvania. He is affiliated with several professional associations and publications and a frequent speaker on behalf of many professional organizations. Mr. Steiber graduated from Washington State University College of Pharmacy. He has participated in a variety of postgraduate programs in law and business development/ marketing at Harvard University and Northwestern University. Mr. Steiber currently resides in Highland Village, Texas.