We Are Getting Older: Focus on Specialty in Long-Term Care

As the population ages, the care of seniors is expanding and specialty pharmacists will play a more active role in patient management and collaboration with other health care providers.

As science and industry continue to provide new life-saving and extending specialty products, our senior populations will grow at an accelerated and disproportionate pace. We learn in every issue of Specialty Pharmacy Times that specialty pharmacies come in many flavors. These include pharmacists who specialize in Long-Term Care (LTC), which includes “senior care”—and this is our focus with this edition of Specialty Pharmacy Times.

Long-Term Care is defined by a number of services provided to patients with a chronic illness or disability. These individuals often need assistance with activities of daily living beyond taking or having their medications administered. It is estimated that more than 25 million people have a condition that causes them to need extra help with medical and non-medical needs, and fully half of these individuals who are over the age of 65 are in LTC facilities.

The demographics are astounding, and the numbers are growing. Seniors needing long-term care are projected to rise to 13.8 million by the year 2030. It goes without saying that the majority of these patients may be on 1 or more medications that we’d define as being in the specialty category. These would include medications for multiple sclerosis, inflammatory disease (rheumatoid arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, psoriatic arthritis, and psoriasis), and oncology, to name a few. Within this elder population, these patients have some of the highest rates of non-compliance with medications and challenges with the “system” in general.

In this issue, our readers will receive some great insight into the fantastic work that is being done around patient care including the active role that pharmacy consultants play in patient management and collaboration with other providers. Drs. Dina and Ness provide us with some great vision into the encounters they’ve observed in navigating the reimbursement challenges for specialty products in an LTC setting by profiling Edwin’s Prescription Pharmacy. Discover how Edwin’s has converted the challenges that specialty medications impose on the long-term care setting into opportunities—in skilled nursing facilities, assisted living facilities, intermediate care facilities and hospice, board and care, and substance abuse facilities. You’ll find this information very relevant if you are a pharmacy, payer, or manufacturer.

Also in this issue, we feature articles on key trends in specialty pharmacy from multiple dimensions as a result of the increased launch of high-cost, low demand products, increased use of biologic products with special storage and distribution needs, increased Risk Evaluation and Mitigation Strategies, increased needs to monitor and track patient compliance, and continued stakeholder consolidation. The University of the Incarnate Word Feik School of Pharmacy graces this month with a comprehensive discussion of the optimization of biopharmaceuticals and how compounds are developed by making slight modifications in drug design and manufacture. These new improvements propel us forward with enhanced options and provide us with an everexpanding portfolio of care solutions for patients.

In Viewpoints, our colleagues from CSPN give us a historical view of specialty pharmacy and how the more things change, the winds of change blow us back to the center of specialty pharmacy— patient care! And stay tuned for the next issue, coming soon, where our authors are hard at work on the second annual Oncology Edition of Specialty Pharmacy Times. SPT

About the Author

Dan Steiber, RPh, is a principal of D2 Pharma Consulting LLC (d2rx .com) and is responsible for commercial operations, trade-supply 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 39-year career. Mr. Steiber is a licensed pharmacist in Texas, Washington, California, and Pennsylvania. He is affiliated with several professional associations and publications and is a frequent speaker on behalf of many professional organizations. He 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 Plano, Texas.