What's Special About Specialty Pharmacy

Jul 8, 2015
Compassionate care, specialized knowledge and a robust suite of cost-saving solutions make Accredo the best choice for specialty pharmacy.

Patients with complex conditions require specialized care – patients like Bernardo, Fernando and Xavier. It takes a specialty pharmacy.

Specialty pharmacies are distinct from traditional pharmacies because they coordinate many aspects of patient care to more effectively manage treatment, side effects and interactions with other therapies.

Medications dispensed by specialty pharmacies often require special storage, handling and packaging prior to dispensing. These products are usually significantly more expensive than conventional medications and require additional controls to assure that patients take them appropriately.

Specialty Pharmacies Provide Better Patient Care

Accredo, Express Scripts’ specialty pharmacy, has cared for more patients living with rare diseases than any other pharmacy in the United States.

Our clinical care model through 13 specialty disease areas is designed to surround patients with the best care. We build drug-specific protocols for every single drug we dispense to make sure every order is safe, effective and affordable. Our Therapeutic Resource Centers are essentially pharmacies within a pharmacy.

More than 1,200 specialty pharmacists, 550 field nurses and 150 patient support staff receive specialized training and spend the vast majority of their time serving patients in a single disease state.

These conditions include:

  • Bleeding Disorders
  • Endocrine
  • Fertility
  • Hepatitis C
  • HIV
  • Immune Disorders
  • Multiple Sclerosis
  • Oncology
  • Pulmonary
  • Pulmonary Arterial Hypertension
  • Rare Diseases
  • Rheumatoid Arthritis and Inflammatory Conditions
  • Transplant

Caring for the Most Complex Patients

Specialty pharmacies like Accredo have become exponentially important as the prevalence and cost of specialty drugs have increased dramatically in recent years and are expected to continue.

In 2014, FDA approvals for drugs to treat rare conditions reached an all-time high. And yet, the pipeline is robust with more than 7,000 drugs in development, of which 29 specialty drugs are expected to be approved this year.

The model of specialty pharmacies results in better health and financial outcomes to benefit payers, physicians, drug manufacturers and – most importantly – patients.

Accredo currently treats approximately 600,000 active specialty patients. The overwhelming majority of these individuals have had an excellent experience, with patient satisfaction levels well above 90% in recent months.

Tailoring service to each individual patient enables us to serve their specific needs based on their condition and their medication.

When a patient requests to speak with a pharmacist in a retail pharmacy setting, consultations last an average of two minutes. In contrast, our average clinical consultations last 15 minutes for patients with rheumatoid arthritis, 15 minutes for patients with hepatitis C, 14 minutes for patients with multiple sclerosis and 18 minutes for patients with cancer. As a result of expanding the clinical care time, we drive better adherence, better health outcomes and lower overall healthcare costs.

For example, Accredo’s clinical care for patients with rheumatoid arthritis results in 16% higher adherence over other pharmacies, 23% few doctor’s office visits, 9% fewer annual ER visits and $1,797 in annual medical cost savings per patient.

Putting Specialty Medications Within Reach

As more expensive drugs come to market, the cost of specialty medications is unsustainable for payers. Utilization management strategies like formulary tiers and medical benefit management are often economic necessities due to the high price tag pharmaceutical manufacturers often put on new drugs.

An Express Scripts study found employers who adopted a tightly managed pharmacy benefit – those whose health plan members used a specialty pharmacy exclusively combined with multiple specialty utilization management programs – saw an annual increase in specialty drug spending per member per year of 13.6%, half that of the unmanaged group (27.8%) and nearly one-third lower than the average annual projected specialty drug trend. In addition, tightly managed programs saw higher average member adherence rates in top therapy classes, such as multiple sclerosis and oncology.

Cutting-edge drug trend management tools guarantee drug spend will be kept in check. This gives payers the stability to plan for the future and avoid trend surprises.

We also offer patient assistance programs (PAPs) to help patients with copayments and other financial assistance so they can continue their therapy. We secured $50 million of financial assistance for specialty patients in 2011, $240 million in 2014, and are anticipating $500 million in 2015.

Partnering with the Healthcare Team

A physician’s time is best served caring for patients. Specialty pharmacists and nurses play an integral role within each patient’s broader healthcare team. Their specialized disease and drug knowledge combined with visibility into a patient’s complete medication profile allows us to proactively identify issues patients may be facing and actively intervene in the case of adverse events or omission of therapy.

This level of knowledge and specialization means we are validating and optimizing every order.

Making Drugs Safer

As drug manufacturers work to bring new medications to market, getting these drugs into the hands of patients and providing them with ongoing care are important considerations. In fact, many specialty and orphan drugs have FDA-mandated risk evaluation and mitigation strategies (REMS). As such, it’s critical for manufacturers to partner with a specialty pharmacy that has the experience and sophisticated protocols necessary to maximize the safe and effective use of these drugs.

Why Specialty Care Matters

If you are diagnosed with cancer, would you rather go to an oncologist or general practitioner? For the same reason, a highly trained oncology specialist pharmacist has a better understanding of to get the most out of your cancer treatment.

A holistic care model offers plan sponsors and patients a clear choice for specialty care. Ensuring the best possible health outcomes for complex patients at prices that plan sponsors can afford is the true value of specialty pharmacy generally and Accredo specifically.

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