What Specialty Pharmacy is and How it Improves Patient Outcomes 

Specialty pharmacies differ, not by location, but by services offered and conditions treated.

When treating chronic and rare conditions, those differences add up to make a big impact on patient success. Studies show that specialty pharmacies are improving drug treatment outcomes and breaking down the barriers that make patient access difficult. Patients facing complex, chronic, rare, or life-threatening conditions rely on the added support and resources a specialty pharmacy provides.

Specialty pharmacies are designed to efficiently manage medications with special requirements such as preparation, handling, storage, inventory, distribution, Risk Evaluation and Mitigation Strategy (REMS) programs, data collection, administration, reimbursement and case management. Specialty pharmacies also provide patients with education, help ensure appropriate medication use, promote adherence and compliance, and help avoid unnecessary costs. Additional support systems help clinicians coordinate information to help patients locate resources that provide financial assistance for out-of-pocket expenditures. 

How Specialty Pharmacy differs

Unlike short-term illness, which can easily be treated and managed by a retail pharmacy, chronic conditions involve drug treatments with extensive needs and adherence protocols. A specialty pharmacy delivers medications with special handling, storage, and distribution requirements. They also work with patients and physicians to tailor treatment plans. An extensive understanding of a patient’s profile helps to limit symptoms, drug interactions, and potential reactions. Also, continued communication with a patient’s physician allows for faster intervention, when needed. One of the more important roles for a specialty pharmacy is to aid with patient education and help ensure appropriate medication use and adherence for the duration of treatment. Medications dispensed by a retail pharmacy are rarely difficult for patients to manage and require little explanation, but specialty drugs often require teaching patients how to take their drugs properly. Specialty pharmacies give important support for medication adherence with a range of helpful tools designed to remind patients to take their medicine exactly as their doctor prescribed. With the help of digital tools like text messaging, e-mail, smart pill bottles, and video training, each patient can receive special coordination, consultation, and training to manage their therapies and adhere to treatment plans.

Specialty Pharmacies Improve Patient Outcomes 

A specialty pharmacy improves clinical outcomes by ensuring medication adherence for patients with chronic and rarer conditions. Additional staff and procedures are available to communicate with patients and extend more complex services. Treating chronic conditions like hepatitis, cancer, HIV/Aids, rheumatoid arthritis, and Crohn’s disease require medications with complicated regimens. Highly skilled health care professionals practicing at specialty pharmacies are often more equipped to provide therapy management and maximize clinical outcomes. Additionally, specialty pharmacies have staff and infrastructure to communicate with patients, offer more support, and improve treatment outcomes by ensuring medication adherence. Medication adherence is critical to improving outcomes because when patients adhere to medication regimens, they increase the effectiveness of a treatment plan. Nonadherence to a drug therapy for certain disease states and conditions can literally be a matter of life and death. Patients can take medications at the wrong time, forget a dose, skip a dose, or take an incorrect dose. Medication nonadherence costs the USA Healthcare system an estimated $672 billion and results in 12 million hospitalizations and over 275,000 deaths annually. Many patients on specialty therapies struggle with multiple medical conditions from their disease such as pain, disability, or fatigue, which are additional factors that can impact the level of adherence to a drug therapy. Also, many chronic patients require multiple medications and managing collective protocols is difficult. Because specialty pharmacies work with physicians, a patient’s unique condition and disease state can be better monitored. Once treatment begins, secondary conditions or new symptoms might present challenges for patients and a specialty pharmacy helps monitor and manage those challenges.  

How Specialty Drugs Differ 

Traditional drug therapies, fulfilled by a retail pharmacy, often come with minimal protocols or distribution requirements. However, specialty drugs may be new, require a complex treatment regimen, or need extensive monitoring.  Drugs that are new to a therapeutic area, make insurance approval more difficult.  A specialty pharmacy works with patients and insurance to make sure approval is streamlined and efficient.  Specialty drugs may also require extensive education to understand drug use, side effects, and symptoms. Some treatments may even be customized for the patient to avoid side effects and symptoms.  Often specialty drugs need to be self-administered, some by injection, which can be challenging to patients. Specialty pharmacy offers instruction and hands-on guidance to patients needing this type of support.   

Specialty Pharmacy assists patients to avoid unnecessary medical costs and help locate financial assistance 

Many Specialty Drugs create potential coverage issues for patients. Some drugs may be expensive and create obstacles for patients to receive the treatment.  Assistance from a Specialty Pharmacy plays a huge role in obtaining the Specialty Drug.  They can investigate the patient’s benefits to make sure coverage is possible for the prescribed medication and once authorization is approved, the pharmacy can submit claims and obtain cost estimations for the patient.  If the patient cannot afford the copay, the pharmacy has an extensive network of financial assistance, subsidies, and manufacturer free-drug programs to draw upon.  Programs like the 340B Drug Pricing Program allow low-income patients to purchase their medications at an affordable price by either paying a reduced copay or no copay.   

Overall, Specialty Pharmacy helps patients through special attention and education. Specialty pharmacies have, and will continue to play a major role in facilitating continued care for patients dealing with complex disease states and challenging therapies. The need to educate, remind, and coach patients is of critical importance to give patients a better experience, adhere to treatment plans, and lead to fewer adverse effects or symptoms.  

PFSP Specialty Pharmacy provides patients and their physicians an exceptionally high standard of care with our growing team of specialized pharmacists and staff.  Our dedicated team of pharmacists focus on improving adherence for patients and work to find an approach that works best for them. Bringing a fresh take on what a Specialty Pharmacy can and should be, we are committed to the care of our patients.  We take pride in being an ethical resource within our community and strive each day to help our patients live enriching and full lives.

Sources: 

What is a Specialty Pharmacy?
https://www.pharmacytimes.com/view/what-is-a-specialty-pharmacy

Partnering with Specialty Pharmacies to Improve Patient Outcomes
https://www.mckesson.com/Blog/Partnering-With-a-Specialty-Pharmacy-to-Improve-Patient-Outcomes/

Pharmacist Interventions to Improve Specialty Medication Adherence: Study Protocol for a Randomized controlled Trial
https://link.springer.com/article/10.1007/s40801-020-00213-8