Working Collaboratively to Achieve Value-Based Care: What’s the Best Way?

Specialty pharmacy is in a “really good place” to work cross-functionally with pharmacists, physicians, and other health care providers toward providing the best value-based outcomes, according to a panel discussion at the Asembia Specialty Pharmacy Summit 2018.

Brandon Tom, vice president and head of Commercial Services and Specialty Pharmacy Solutions for McKesson Specialty Health, led the discussion, joined by Keith Cook, vice president of MedImpact Direct Specialty Operations, and Michael Leach, vice president of market access at Tesaro Inc.

Leach said there are a number of specialty pharmacy programs that serve as good examples of the collaborative care model, ones that involve reaching out to patients and helping them with questions regarding their prescription regimens. Cook mentioned MedImpact’s Direct model—in which patients can access a portal to track their own scripts—as a digital-focused collaboration that keeps patients at the forefront of their own care.

Leach addressed the challenges of defining what value-based care entails, and he addressed the difficulties in finding strategies that are successful for all parties. All the panelists agreed that the main challenges center on the contracting phase on the front end, defining what the manufacturer can agree to, and whether the pharmacy can, in fact, provide that care given the available treatment options for an illness.

Cook and Leach agreed that oncology poses particular challenges for value-based care because of the complexities in defining what the best measurable outcomes are in this challenging patient population.

“What does good look like, and how do we measure it in an appropriate way?” Leach said. “The fact is, we all want to do it, we all think it makes sense, but the difficulty is finding a process and a strategy that will work for all of us.”

He added, “The difficult thing for an oncology company like ours is: How do you measure oncology outcomes, how many months of progression-free survival...how do you determine a successful versus an [unsuccessful] trial?"

Leach said this differentiates cancer care from many other areas of specialty, in which the outcomes are more defined. He pointed to cure rates in patients with hepatitis C as an example in which the value-based care model can work well.

At the end of the discussion, Tom queried the panel about the steps needed to truly achieve value-based care. Leach emphasized the importance of maintaining small, collaborative networks that all have a patient-centered focus.

Cook echoed Leach’s sentiments, noting that his company operates differently from other phar- macy benefit managers on the market because it doesn’t collect direct and indirect remuneration fees. He said this was an important decision because it allowed for a more open and honest conversation with patients and providers, leading to the best solution for each patient.