Our client, a regional health center located on the shores of beautiful Lake Michigan, is invested in community support. Their facility has built a favorable presence in a bustling community filled with businesses, colleges, and summer vacationers.

They offer a wide variety of general and specialty care services, including neurology, rheumatology, and gastroenterology. Despite its strong community presence and high provider satisfaction, the health center continually seeks efficiencies and improvements in patient care.

Identifying the Need for Specialty Pharmacy Services

Medication access services weren’t available to these patients. Historically, patients in the area requiring specialty medications would either choose a specialty mail-order pharmacy or be directed to one by their insurance. 

Our client saw specialty pharmacy as an opportunity to provide better, more comprehensive care to their patients. They knew making these life-saving medications available internally would improve medication access, convenience, and patient care. 

Although expanding into specialty pharmacy was an exciting goal for the healthcare team, their staff was already stretched beyond capacity. And that’s where the Visante team comes in. 

A Powerful Partnership Unlocks New Opportunities

Once the health center team learned about Visante’s full medication access services, they realized that the opportunity to build a specialty clinic held more value than they initially thought. They uncovered financial performance upsides that would result in a positive return on investment (ROI) and help fund other critical patient care initiatives down the line. Expanding into specialty pharmacy would greatly benefit the hospital’s patients, providers, operations, and the bottom line.

A Rapid & Efficient Strategy 

The timeline needed to move quickly and clear communication was critical to the project’s success. They needed to earn accreditations, gain purchasing agreements, build facilities, and develop staffing in record time. 

So, the teams went to work immediately: 

Strategy & Timeline 

Visante created a pro forma, finalized a strategic roadmap for the organization, and identified the financial benefits that would yield a positive ROI and support future patient care initiatives. 

Getting Necessary Approvals 

The health center leadership provided approvals and support, bringing in essential individuals for development, implementation, and service delivery.

Our client-dedicated internal support staff—including a project manager and pharmacy manager—to keep the project on schedule. 

Collaboration is Key 

Visante collaborated with the cross-functional team, managing all project aspects to ensure comprehensive representation and support. We worked closely with the health center to overcome challenges, establish fresh approaches to current workflows, and implement best practices that greatly benefited the organization’s ability to deliver best-in-class service. 

Results: Specialty Pharmacy Makes a Positive Impact

The health center met its ambitious goal of launching its specialty pharmacy in record time. Now, it provides an exceptional patient care experience that improves outcomes and keeps patients connected to their care teams. Patients are delighted with the convenience and support they feel from the health center! 

“It’s amazing to work with an organization completely committed to its patients and community. Everyone involved in this project went over and above to create a service that will truly benefit patients and their families.”

-Lynn Thoma, Visante Senior Consultant

Our client is dedicated to patient care excellence and serving their community. This means that specialty pharmacy was an important addition that will significantly impact their patients, providers, operations, and the organization’s overall well-being. 

Ready to Transform Your Pharmacy Services?

If you’re a pharmacy leader looking for ways to optimize processes and improve patient care, email solutions@visanteinc.com or call (866) 388-7583 to speak with one of our team members. We’re excited to talk with you about how we can adopt a specialty pharmacy framework for your organization. 

The number of accredited specialty pharmacies continues to grow – from 378 to 1,207 since 2015 – and much of this growth is driven by health systems, which now make up about 39% of the total figure. But even though many health systems have some sort of specialty pharmacy, most still have quite a bit of untapped potential. When properly implemented, specialty pharmacy can touch and improve all other areas of your health system, including infusion care services, 340B program performance, system-wide financials, and more.

Here is a look at what a specialty pharmacy is and how adding this service to your health system can have long-lasting, far-reaching advantages.

What is a specialty pharmacy?

A specialty pharmacy provides very high-cost medications used to treat rare or complex health problems. In many cases, specialty products are used by fewer people, so local pharmacies likely don’t have them in stock or cannot supply them due to payer or manufacturer restrictions. This is where a specialty pharmacy comes in.

Specialty vs. Non-specialty products

Non-specialty products constitute the vast majority (>99%) of prescriptions filled by consumers nationally. From the retail or community pharmacy perspective, they are primarily volume-driven and usually result in very minimal or even lost profit margin. Because of this, many independent pharmacies have been struggling to turn a profit.

Specialty products, on the other hand, constitute less than 1% of total prescription volume but account for over 50% of the nation’s drug spend. Due to their high cost, pharmacy profit margins can be substantial once an organization establishes specialty pharmacy services, collaborates with clinics, and increases their patient recruitment and retention.  

Key variables that might make a product a “specialty product” include:

• They are disease-state focused. For example, the core drug therapies for oncology, rheumatology, gastroenterology, and endocrinology are specialty products.
• They involve a drug approval process, wherein the FDA might say the product has dangerous side-effects that require additional screening.
• As part of the above process, the manufacturer has to certify pharmacies to provide the products. If a drug is approved with a risk evaluation and mitigation strategies (REMS) program, the manufacturer may have to certify specific pharmacies, which inherently creates a smaller network of pharmacies that would be included.

As a general rule of thumb, if a drug is particularly expensive, it is most likely a specialty product.

Why should health systems have specialty pharmacies?

Reasons to add a specialty pharmacy to your health system include:

• Improved financial performance and a new source of revenue for the organization
• Improved patient care with the ability to holistically manage complex patients within the health system between provider and pharmacy.
• Improved efficiency in the ability to serve patients within the health system to ensure their drugs get to them before they leave the hospital.
• Increased provider visibility into patient care by delivering specialty products within the health system to help providers know what is going on between visits (rather than waiting nine months between visits to get an update).
  • Specialty pharmacy provides visibility into every aspect of care, as everything is documented internally, including information on side-effects and adherence problems.
• Improved clinic and provider efficiency by offloading complex prior authorization and insurance-related paperwork out of the clinics and to highly skilled and lower-cost pharmacy personnel.

Visante’s approach to specialty pharmacy

At Visante, our clients are our partners, and we believe holistically that the internal health system’s specialty pharmacy business model is best for patients and for health systems. Unlike our competition, we quickly develop clients to the point of self-sufficiency and high performance via our customized implementation service model.

We support health systems to implement and manage all aspects of their internal program in a manner which maximizes early and long-term financial returns. We recognize that no two programs are exactly alike, and we take pride in developing customized solutions for clients that are highly configured to their environment.

Our goal with our specialty pharmacy services is simple: to drive value for health systems in terms of their specialty pharmacy performance while improving patient care and solving a workforce need in the marketplace.

Contact us today to learn more.

Join Steve Rough and Joe Cesarz, as they discuss the importance of focusing on specialty pharmacy services.