With the continued growth of specialty pharmacy services, the industry is seeing a major trend in health systems and integrated delivery networks (IDNs) joining the ranks of providers. By establishing their own specialty pharmacies internally, IDNs are able to leverage better control over drug selection and prescribing, patient care and outcomes, and gain share in the increasingly lucrative specialty market.
While some may consider IDNs “late to the game,” these organizations offer some unique and critical advantages over large national chains and independent specialty pharmacies. The IDN’s access to the comprehensive electronic medical record (EMR), as well as increased face-to-face interactions with care teams and patients, offers insights and specialty data that pharmaceutical companies and third-party payers are constantly searching for.
Key Disruptive Market Trends for IDNs
HIRC’s research identifies some of the most disruptive trends influencing IDN participation in the specialty pharmacy industry, which include:
- The rise of specialty drug and supply costs
- A shift to value-based care
- Advanced HIT capabilities to help ensure evidence-based care
- Increased risk in the accountable Care Organization (ACO) model
IDN executives indicated that these trends have the highest potential to affect their businesses, suggesting that they’ll continue to influence IDNs for years to come. As a result, a significant number of IDNs are harnessing the opportunity to provide specialty pharmacy services as a means of maximizing performance and outcomes.
The Advantages of Specialty Data
The EMR provides IDNs access to and control of data that even the most accomplished specialty pharmacies typically do not have. This is partially attributed to the nature of the IDN: specialty pharmacists within these organizations regularly work within the clinic, collaborating with a range of healthcare providers from physicians and nurses to dieticians and social workers. This integration of care gives comprehensive and multi-faceted insights into each patient’s condition.
Additionally, pharmacies are often co-located or adjacent to the clinics where specialty pharmacy patients visit for regular care. This opportunity for face-to-face interaction provides more insights and feedback from the patient than is provided via telephonic, mail, or text interactions.
Growth toward Integrated Care Models and Value-Based Pricing
Industry leaders predict that IDN specialty data will play an integral role as the industry continues to grow toward integrated care models and value-based pricing. Russel Allinson, RPh, MS, Therigy’s CEO, and Chief Clinical Officer, noted in a January 2017 Specialty Pharmacy Continuum interview that clients who provide specialty pharmacy services within IDNs have the ability to track ER visits and inpatient readmissions, intervene when therapy is ineffective, closely monitor adverse events, and evaluate patient-specific drug effectiveness.
He went on to explain, “These SPs also have easy access to definite therapeutic endpoints, like the SVR results for a hepatitis C patient on direct-acting antivirals. Looking long term, what most of these systems want to do is manage the total care of these patients across disease states – including all of their drug therapy – in order to maximize the value of the care they’re providing. Integration of specialty pharmacies and their data in the overall pharmacy services of the IDN clearly plays an important role in achieving that goal.”
Data Organization through Specialty Therapy Management Platforms
While IDNs have access to critical data for top performance in the industry, it’s equally critical to ensure that this data is organized and accessible in a meaningful way. For example, manufacturers and payers have strict data structure and data reporting requirements that mandate reports on a daily, weekly, or monthly basis.
Many specialty pharmacy providers, including those operating within IDNs, are relying on specialized therapy management platforms like TherigySTM, which provides pre-configured disease-specific care plans with clinical assessments, data integration capabilities, advanced reporting, and more. Learn more about TherigySTM’s full capabilities and whether it’s the next step for your health system or IDN.