Lower hospitalization and emergency visit rates mean lower long-term costs for patients on your medication. But, with your therapy, fewer patients need hospital or emergency care, because it has fewer side effects. Analytic value. You can leverage this data to understand the key players in the specialty pharmacy arena and how these entities are moving and transforming in real time. This data can be provided by phone, by email and by text. Electronic patient-reported outcomes systemsâor ePROsâlet patients use their laptops, tablets, smartphones and even pill-bottle sensors to send in their data. The role of specialty drugs in the pharmacy industry; Our latest data on specialty pharmacy accreditation; Commentary on PBM’s role in the specialty industry; The data are drawn from our 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. The most successful approach to data analytics is based on aligning a manufacturer’s specialty pharmacy data requirements with its business needs, therapy category and pharmacy capabilities. These data are reported in many different formats, which produces a time and cost intensive scrubbing process to make it actionable. Specialty pharmacies collect clinical and financial data. Monitoring incoming patient status updates for data quality issues helps your SP Account Management team to implement weekly/monthly processes to review trends and hold SPs accountable to contractual obligations. Data requirements largely consist of patient and prescriber demographics details, claims and dispensing information, call center metrics, and clinical data. Here are four ways you can use this data for your benefit. Building A Wall Wonât Prevent A Global Pandemic, The shape of life: polio, disease and my mum, How Climate Change Is Challenging American Health Care, Why Some Americans Are Risking It and Skipping Health Insurance. What other medical conditions do your patients have? Most importantly, the data collected by specialty pharmacies can improve the therapeutic value of your drug and lead to better outcomes for patients. Published Online: Wednesday, Jul 25, 2018. Providers and vendors should work with SDOs and professional pharmacy associations represented by the Pharmacy HIT Collaborative to implement standards for interoperability and data exchange. Outlining clinical data standards would guide software vendors to develop solutions that allow the documentation, reporting, and exchange of clinical data consistently across the healthcare system. This would provide a true solution for population health analytics and value-based reimbursement. Specialty Pharmacy Data Elements • New/Refill Prescription numbers • Profit margin per Rx (drug, payer, overall) • Broken down by therapeutic category • Patient numbers per drug, payer, prescriber • Pull out numbers from traditional business Accreditation These pharmacists treat those with cancer, multiple sclerosis (MS), autoimmune diseases, and other chronic conditions. Strengthen your drugâs therapeutic value. Specialty pharmacists work closely with the clinicians Introducing Specialty Data Rx. There are data capture points within those conversations and these assessments are customized to match each disease and drug. He explained that specialty pharmacies are in a unique position to monitor patient response to your drug. across specialty pharmacy data sets without ever exposing the underlying PHI. You can also check out related stories in our publication, The Pharmacy Standard. As technology evolves, data continue to be a key component of patient care in the specialty pharmacy (SP) landscape. I agree with Brandon. Products are dispensed by CVS Specialty and certain services are only accessed by calling CVS Specialty directly. A standardized approach to documenting, storing, reporting, and exchanging specialty data would provide great benefits to all stakeholders in this high cost marketplace. How are patients responding to your drug? Data is valuable currency to your biopharmaceutical company. You can use all this information to improve your therapy for patients who depend on itâand it all starts with the data that specialty pharmacies collect. Directly accessible data for 170 industries from 50 countries and over 1 Mio. You may be able to reformulate your drug, reduce the pill count and improve adherence. She has over 25 years of experience in nursing, focusing most of her career in oncology. To learn more about this upcoming release and how you can more easily understand the complicated market of specialty pharmacies, contact us and mention the Specialty Rx product. How much financial help do foundations give to your patients. What actions did the pharmacy take to control those side effects? The data flags the causes of nonadherence and points you to a solution. Data have a major impact on the industry for clinical and business reasons. Tokenbased - matching supports the creation of a longitudinal record of a patient’s specialty prescriptions, regardless of where the drug was dispensed. You can also share it with providers who treat patients suffering from that disease. When do those side effects occur along a course of therapy? Puerto Rico requires first-fill prescriptions to be transmitted directly to the dispensing specialty pharmacy. Oftentimes, the incompleteness can make the data difficult to use. There are no requirements that specifically target specialty pharmacy providers or specialty pharmacy vendors. Medicines in this field include everything from standard oral to infusions specialized biologic products. strategies to address specialty pharmacy, including functioning as a specialty pharmacy themselves, formally partnering with a specialty pharmacy, and receiving products from specialty pharmacies as determined by payer or manufacturer.2 For the purposes of this document, specialty pharmacy and specialty pharmaceutical are defined in Table 1. DATA FIELDS The database, with 1,000+ pharmacy locations, updates its … What side effects or adverse events are patients experiencing with your drug? The collaborative has developed a process to publish documentation codes in form value sets that align with standards for interoperability and data exchange for clinical pharmacy. Specialty Pharmacy Analytics www.hdms.com | 312.701.1320 With specialty pharmacy analytics, organizations can: » Track specialty drug trends year-over-year to support forecast models and understand the financial impacts of specialty pharmacy needs within specific populations. ... Cigna's Accredo/Freedom Fertility revenue accounted for 20 percent of all Rx specialty pharmacy … What payer formularies include or exclude your drug? Specialty pharmacy evaluation and defining service-level agreements. Ann Steagall is Director of Clinical Policy at Biologics. Specialty Pharmacy Solutions for Patients and Caregivers. Specialty pharmacies collect clinical and financial data. High cost pharmaceutical products are dispensed by specialty pharmacies to treat complex and often rare disease states. Your drug is out there in the real world. By using these assessments, the pharmacies collect the same data points from each type of patient on each type of drug consistently over time. Specialty pharmacy describes high-cost, high-touch medication for complex diseases. Utilizing specialty pharmacy–provided physician dispensing data, drug utilization data, and de-identified patient demographic data leads to more effective use of their products. Several industry groups are identifying clinical data elements for common specialty pharmacy disease states, including hepatitis C, rheumatoid arthritis, and multiple sclerosis. Several industry groups are identifying clinical data elements for common specialty pharmacy disease states, including hepatitis C, rheumatoid arthritis, and multiple sclerosis. In his blog post, my colleague Brandon Tom wrote about how your biopharma company can benefit from working with a specialty pharmacy. We have therefore used various methods and primary sources to estimate the data. Letâs say your drug and a competing drug produce the same outcomes. There is still more work required to achieve a data environment to leverage data exchange health analytics. facts. This data can be provided by phone, by email and by text. Maybe your drug is effective at treating an additional condition or subset of patients. With the Wellsky specialty pharmacy software, CareTend, save time, fulfill orders quicker, and maximize growth with real-time business intelligence tools.Built to manage compliance and the complex workflows unique to specialty pharmacies, our all-in-one solution helps your … deliver comprehensive data that’s pulled directly from patients’ electronic health records. The issue could be cost, for which financial help is the answer. NOTES FOR NERDS. Specialty pharmacy leaders should work closely with accreditation agencies, standard development organizations, vendors, the Pharmacy HIT Collaborative, and other stakeholders to develop a strategic plan for implementing data standards across the industry. Today's specialty products require a litany of complex processes to create the optimal commercial strategy. Quality organizations, such as the Pharmacy Quality Alliance (PQA), should expand quality measures for specialty pharmacy. Better adherence leads to better outcomes. MSA Healthcare Data Management's patented de-identification and integration processes help pharmaceutical manufacturers (pharmas) trying to obtain and understand Specialty Pharmacy Data see the big picture. It could be pill fatigue, which pharmacies could relieve through counseling. Enjoy this post? The best way to gather this data is by partnering with a specialty pharmacy. specialty pharmacy and delivered to their home. This blog has been crossposted from an original article published in May 2017 in Specialty Pharmacy Times. In the past, implementation has been expedited thanks to federal mandates or financial incentive programs (e.g. Maybe the efficacy of your drug peaks after a certain amount of time. Letâs say the data tells you that patients stopped taking your drug because they have too many pills to take in one day or over a course of treatment. Pharmacies use clinical assessments to guide their talks with patients, which is also one of the main ways they collect data. But as a catch-22, the high volume of data can become overwhelming if it’s not harnessed and organized. Quality measures allow payers and providers to quantify performance to set quality standards for the industry. Many companies do not report prescription revenues from specialty drugs. The EHR is already integrated into the health system. Among other strategies, specialty pharmacies may report data to pharmaceutical manufacturers and payers to gain access to limited distribution drugs (LDDs) and carved into payer contracts. According to the American Pharmacists Association (APhA), "Historically, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs. We give providers up-to-date access to compare current drug prices, giving patients access to some of the more expensive brands and some of the hard to get covered generic medications. The Specialty Pharmacy Times Industry Guide is setting the standard on providing commercialization tools for both the industry and pharmacies in the area of specialty therapeutics. A specialty brand’s goals for diagnostic patient journey analytics and actionable insights are highly dependent on decisions made when drawing up specialty pharmacy provider (SPP) data contracts. Specialty pharmacy is a unique and complex sector of the health care industry. Samm Anderegg, Pharm.D., MSCEO | DocStation. Insights from your specialty pharmacy information. Anecdotal reports from specialty pharmacy leaders working closely with manufacturers and payers report that many of these stakeholders are unable to specifically identify additional data they are interested in; however, they know it is important. That puts pharmacies in a great position to gather information. These buyers want the best outcomes for the lowest cost. By using these assessments, the pharmacies collect the s… Manufacturers, payers, and specialty pharmacies would benefit greatly from a robust data infrastructure allowing cleaner and faster reporting to stakeholders. Click here to contact the team at DocStation. *Make no mistake – the specialty pharmacy market is hot. Ongoing nursing support, as well as follow-ups, are provided through the specialty pharmacy service center via e-mail or phone. Clinical data (ie, past medical history, family history, adverse drug event history, genomics information, laboratory values, procedures, interventions, and outcomes) are difficult to obtain because of inconsistencies in legacy documentation practices and proprietary medical record systems that contain the information. Pharmacy benefit management — working with employers, health plans companies and government programs — dominate the specialty pharmacy market in the United States since at 2008. Accreditation agencies should align data requirement with standards developed by NCPDP and other SDOs. The Pharmacy HIT Collaborative works closely with federal partners, SDOs, and pharmacy professionals. ©2016 Health Data & Management Solutions, Inc. Most importantly, this would be valuable to patients who would benefit from quality transparency, driving market competition, better quality, and lower cost health benefits, as well as faster-to-market, cutting edge treatments. Specialty pharmacies perform a number of patient management services for you and the prescriber. Pharmas who understand data and can make intelligent, meaningful data connections have a competitive edge. The data you collect from specialty pharmacies can help you demonstrate the value of your drug to health plans, pharmacy benefit managers, employers and other payers. Several services within SP are data dependent, with many of them being measured from an aggregate level, such as inventory control and patient services. This allows pharmacists to access existing information on patients, such as labs, current medications, and doctor visits. Determine if a specialty pharmacy needs to reposition as centers of excellence in key areas of practice. What is the average co-pay a patient experiences? Unlike retail pharmacy where there is limited utilization of many drugs across thousands of pharmacies, specialty pharmacy dispenses many prescriptions of a particular product in a very limited number of pharmacies. You need data to tell you how things out of your control are influencing the efficacy of your drug in a new patient population. Data Aggregation Platform. This is especially important for high cost, resource-intensive specialty pharmacy industry. SPECIAL NOTE: Patients with hearing impairments may choose to communicate with our staff via a National TTY-TTD telephone line at 711. Other sectors of the health care system can follow this framework to leverage health data. Now, the question is what you can do with all this information. By mining patient-level outcomes data, a Specialty Pharmacy can analyze the efficacy and safety profile of a specific treatment. Information technology standards provide a systematic, unified approach to ensure data are produced, managed, and reported consistently, ultimately leading to health information exchange capability. The ability to collect and aggregate data is essential for success in specialty pharmacy. The data you collect from specialty pharmacies can tell you why patients arenât taking your drug. We assist companies in: Data source onboarding, data quality, and data supplier performance management. Technology is also making it possible for patients to electronically report their experiences and outcomes directly to specialty pharmacies. Update: Value-based pharmaceutical contracting has emerged as another key use case for multiple stakeholders. Are those side effects expected or unexpected? If it performs better than a competing drug for the same disease, thatâs information you can share with patients through advertising. In this situation, data on hospitalizations and emergency department visits can be useful to your biopharma company. The use of big data is by no means a new phenomenon in health care. A framework exists for the standard exchange and consistent reporting of health information. For more, see Chapter 3 of our new report, which provides a comprehensive analysis of the specialty pharmacy market and detailed profiles of the largest specialty pharmacies shown above. Thatâs value for payers. Value sets provide a subset of standardized data elements needed for reporting and exchanging clinical information. All stakeholders would benefit from specialty pharmacy data standards. Discontinuation data is also important from a commercialization and brand strategy standpoint. Specialty Drugs Replace Traditional Drugs as Growth Drivers . Specialty Pharmacy data analytics that aggregate Specialty Pharmacy data with data from other sources can measure both the effectiveness of pharmacy care and product performance. As I mentioned, they fall into two buckets: clinical and financial. Aligning industry stakeholders would provide a consensus-driven process for identifying data elements and interoperability standards to create a robust data infrastructure for the health care system. In her role, she leads the clinical oversight committee, manages the development of care plans and clinical assessments, facilitates training for clinical and non-clinical team members and collaborates with the biopharma business development team on new therapy launches. By Karen Tirozzi. Related: Learn more about McKessonâs specialty pharmacy services for drug manufacturers. All communications via that telephone line are confidential and compliant with FCC confidentiality guidelines. Manufacturers could use clinical data to study post-market adverse drug events and patient-specific outcome variations in relation to genomic profiles, providing enhanced insight into research and development efforts. Standard development organizations (SDOs), such as HL7 and NCPDP, have developed standards for documenting and exchanging electronic health information including Fast Healthcare Interoperability Resources (FHIR) and the SCRIPT standard. The same process can also be leveraged for specialty pharmacy data. MedicoRx® Specialty Pharmacy is licensed in the state of California. With specialty pharmacy analytics, organizations can: Track specialty drug trends year-over-year to support forecast models and understand the financial impacts of specialty pharmacy needs within specific populations. How many times do your patients go to the hospital or emergency department? Those factors can be other drugs, social determinants of health, other medical conditions, unknown or unmitigated side effects, and time on therapy. As the providers most closely tied to this industry, the professional pharmacy community should take this opportunity to provide guidance to the federal government on strategy to standardize data for specialty pharmacy disease states and outcomes. Ever since electronic health records were mandated, in 2004, the industry has dreamed of rich, structured, and minable digital data sets. What is the payer mix of the patient population taking your drug? Without reporting data, specialty pharmacies may struggle to access LDDs, forcing patients to use preferred specialty pharmacies, driving business to their competitors. Over the past several years, the introduction, utilization and cost share of specialty pharmacy products has been increasing at a rate substantially greater than that of other pharmaceuticals.1This paper examines the characteristics of specialty pharmaceuticals; the growth of new expertise to handle and manage these pharmaceuticals; and the needs these products create for patients, health plans and practitioners. *Specialty delivery options are available where allowed by law. The level and complexity of the data that must be collected for the specialty pharmaceutical and patient goes well beyond the traditional transaction-based data required for typical chronic medications. In-store pick up is currently not available in Oklahoma. For prescribers, the value is outcomes, and outcomes depend on adherence. Data related to drug outcomes is essential in your commercialization plan. As a trusted specialty pharmacy provider, we are focused on assisting patients, families and caregivers through the complex healthcare maze of … Some data comes from a patientâs EMR, but most of it is collected directly from the patient. Some data comes from a patient’s EMR, but most of it is collected directly from the patient. There are data capture points within those conversations and these assessments are customized to match each disease and drug. In fact according to data published by the IQVIA, U.S. specialty pharmacy industry revenues jumped from 34.9 percent of the overall pharmacy industry in 2014, to 45.4 percent in 2018. Manufacturers can become overwhelmed with specialty pharmacy data complexity. Some specialty pharmacies build a program for data collection internally, others purchase a third-party platform, and still others configure the health system’s existing EHR to fit the pharmacy’s needs. Specialty Pharmacy Is Different. meaningful use). Click here if you can’t see the video below. Effective data aggregation is the key to building a comprehensive patient-level integrated specialty pharmacy dataset. How Specialty Pharmacy Data Can Boost Your Drugs Success, Partnering with a Specialty Pharmacy to Improve Patient Outcomes, Business Consulting & Revenue Cycle Analytics, Oncology EHR, Regimen Support & Analytics, specialty pharmacy services for drug manufacturers, Drive the commercialization and brand strategy of your drug, Demonstrate the value of your drug to health plans and other payers, Strengthen your relationships with prescribers and other providers, Improve outcomes by enhancing the therapeutic value of your drug. For specialty pharmacies, data is critical to every aspect of operations. In this blog post, Iâll show you how to use specialty pharmacy data to ensure your therapyâs clinical and financial success. And better outcomes strengthen your relationship with prescribers and build brand loyalty to your drug and your biopharma company. How well does your drug treat the disease it was prescribed for? Specialty Pharmacy Data Analytics . When we replace manual work with an accurate, electronic workflow, patients get essential therapies sooner and specialty pharmacists have more time to do what matters most to them: help patients. The pharmaceuticals manufacturer then contracts with the specialty pharmacy to regularly track the patient’s adherence, report any adverse events, and address The following are proposed actions for the specialty pharmacy industry. Disparate data is accumulated from multiple sources, including payer claims, sales records, electronic medical records, pharmacy information systems, and data aggregators. Hospitals, clinics, and pharmacies could use the data to identify patients at highest risk and provide focused interventions, improving outcomes and benchmarking data to drive competition. Weâre passionate about creating tools to improve health and delivering a delightfully unexpected experience for patients & providers in a world where their experience is usually an afterthought. It could be side effects, which pharmacies can help control. It can tell you how well your new specialty drug is working for patientsâand point out ways to make it work even better. These services fall into three areas along the continuum of care: As you can see, specialty pharmacies have a lot of control over how patients access and use your drugs. Pharmacists may also identify tools in the EHR that they can put to use in the specialty ph… On the clinical side, your specialty pharmacy can uncover the following data: On the financial side, your specialty pharmacy can determine the following: Specialty pharmacies collect all of this information and send it to a data aggregator. And he stressed the need to work with a pharmacy that has great data collection and reporting capabilities. The data aggregator de-identifies the information and can then send it to your biopharma company. . Each time a pharmacy touches your patient, that touch is a chance to collect an invaluable piece of data for your biopharma company. Pharmacies use clinical assessments to guide their talks with patients, which is also one of the main ways they collect data. The United States Department of Health and Human Services, and associated entities, including the Office of the National Coordinator and the Centers for Medicare and Medicaid Service are driving implementation of data standards. About DocStationDocStation is a technology company that connects payers and pharmacists to run value-based care models. Specialty Pharmacy Data More Important Than Ever. She earned her bachelorâs degree in nursing and social work from Mars Hill College. Setting quality benchmarks incentivizes providers to optimize treatment regimens and strategies to achieve the best possible patient outcomes. You can use the data from specialty pharmacies to: First, let me tell you where that data comes from. Our Specialty Pharmacy Analytics and SP Scorecards diagnose performance and identify actionable coaching opportunities. How adherent are your patients to your drug? And I think heâd also agree with me that data is just a lot of numbers unless your biopharma company knows what to do with it. A strategy must be developed to incentivize adoption of electronic standards for specialty pharmacy. IQVIA's patented patient de-identification process enables the ability to aggregate anonymous patient-level information and integrate data from multiple sources so you can make more informed decisions. A Specialty Pharmacy drug pricing app that streamlines and organizes drug pricing data. Depending on which forecasts you look at, the general consensus is that over the next few years specialty products will comprise 33-50% of all pharmacy benefit spending. In a session presented by Pharmacy Times Continuing Education™ at the Asembia […] Itâs no longer in a controlled clinical trial setting with a narrow group of patients. Specialty pharmaceuticals are more challenging to track and understand performance. Payers could use the same data to identify high quality providers for accountable care networks, design more precise risk modeling calculations, and gain greater insight into the care provided to beneficiaries. So which data elements can be most helpful to your biopharma company? Update: Many of these initiatives are now underway. 4. NCPDP has a specialty pharmacy workgroup to discuss common interests and construct a consensus-driven data management strategy for specialty pharmacy. Most specialty pharmacy data today are administrative and lack patient-specific clinical information. All these options bring advantages and challenges. Being diagnosed with a complex disease can be overwhelming. Quality measures bring data elements and standards full circle to measure the value of care provided. What are the reasons when patients discontinue your therapy? Docstationdocstation is a technology company that connects payers and providers to quantify performance set! 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