Are those side effects expected or unexpected? In-store pick up is currently not available in Oklahoma. across specialty pharmacy data sets without ever exposing the underlying PHI. 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. *Make no mistake – the specialty pharmacy market is hot. Maybe your drug is effective at treating an additional condition or subset of patients. Specialty pharmacists work closely with the clinicians *Specialty delivery options are available where allowed by law. Most importantly, the data collected by specialty pharmacies can improve the therapeutic value of your drug and lead to better outcomes for patients. Your drug is out there in the real world. Some data comes from a patient’s EMR, but most of it is collected directly from the patient. We assist companies in: Data source onboarding, data quality, and data supplier performance management. 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. The pharmaceuticals manufacturer then contracts with the specialty pharmacy to regularly track the patient’s adherence, report any adverse events, and address When do those side effects occur along a course of therapy? 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. He explained that specialty pharmacies are in a unique position to monitor patient response to your drug. 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. 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. Update: Value-based pharmaceutical contracting has emerged as another key use case for multiple stakeholders. 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. There are data capture points within those conversations and these assessments are customized to match each disease and drug. Related: Learn more about McKessonâs specialty pharmacy services for drug manufacturers. Oftentimes, the incompleteness can make the data difficult to use. Several services within SP are data dependent, with many of them being measured from an aggregate level, such as inventory control and patient services. Specialty Pharmacy Solutions for Patients and Caregivers. NOTES FOR NERDS. Specialty pharmacies perform a number of patient management services for you and the prescriber. In the past, implementation has been expedited thanks to federal mandates or financial incentive programs (e.g. Specialty Pharmacy Is Different. The issue could be cost, for which financial help is the answer. 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. A framework exists for the standard exchange and consistent reporting of health information. Specialty Pharmacy Data More Important Than Ever. The data you collect from specialty pharmacies can tell you why patients arenât taking your drug. Ongoing nursing support, as well as follow-ups, are provided through the specialty pharmacy service center via e-mail or phone. 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. Medicines in this field include everything from standard oral to infusions specialized biologic products. Quality organizations, such as the Pharmacy Quality Alliance (PQA), should expand quality measures for specialty pharmacy. Introducing Specialty Data Rx. Several industry groups are identifying clinical data elements for common specialty pharmacy disease states, including hepatitis C, rheumatoid arthritis, and multiple sclerosis. Utilizing specialty pharmacy–provided physician dispensing data, drug utilization data, and de-identified patient demographic data leads to more effective use of their products. 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. So which data elements can be most helpful to your biopharma company? Technology is also making it possible for patients to electronically report their experiences and outcomes directly to specialty pharmacies. There is still more work required to achieve a data environment to leverage data exchange health analytics. Data Aggregation Platform. 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. Each time a pharmacy touches your patient, that touch is a chance to collect an invaluable piece of data for your biopharma company. You can use the data from specialty pharmacies to: First, let me tell you where that data comes from. The best way to gather this data is by partnering with a specialty pharmacy. Data is valuable currency to your biopharmaceutical company. facts. A strategy must be developed to incentivize adoption of electronic standards for specialty pharmacy. As technology evolves, data continue to be a key component of patient care in the specialty pharmacy (SP) landscape. 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. According to the American Pharmacists Association (APhA), "Historically, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs. You may be able to reformulate your drug, reduce the pill count and improve adherence. We have therefore used various methods and primary sources to estimate the data. The Pharmacy HIT Collaborative works closely with federal partners, SDOs, and pharmacy professionals. There are no requirements that specifically target specialty pharmacy providers or specialty pharmacy vendors. 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. This is especially important for high cost, resource-intensive specialty pharmacy industry. Quality measures allow payers and providers to quantify performance to set quality standards for the industry. Most specialty pharmacy data today are administrative and lack patient-specific clinical information. What payer formularies include or exclude your drug? Some data comes from a patientâs EMR, but most of it is collected directly from the patient. Information technology standards provide a systematic, unified approach to ensure data are produced, managed, and reported consistently, ultimately leading to health information exchange capability. 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. Tokenbased - matching supports the creation of a longitudinal record of a patient’s specialty prescriptions, regardless of where the drug was dispensed. Pharmacies use clinical assessments to guide their talks with patients, which is also one of the main ways they collect data. Specialty pharmaceuticals are more challenging to track and understand performance. Without reporting data, specialty pharmacies may struggle to access LDDs, forcing patients to use preferred specialty pharmacies, driving business to their competitors. That puts pharmacies in a great position to gather information. She earned her bachelorâs degree in nursing and social work from Mars Hill College. These data are reported in many different formats, which produces a time and cost intensive scrubbing process to make it actionable. 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. A Specialty Pharmacy drug pricing app that streamlines and organizes drug pricing data. 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. 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. Specialty pharmacies collect clinical and financial data. The same process can also be leveraged for specialty pharmacy data. Specialty Pharmacy Data Analytics . The EHR is already integrated into the health system. In his blog post, my colleague Brandon Tom wrote about how your biopharma company can benefit from working with a specialty pharmacy. Products are dispensed by CVS Specialty and certain services are only accessed by calling CVS Specialty directly. 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. Thatâs value for payers. You need data to tell you how things out of your control are influencing the efficacy of your drug in a new patient population. By using these assessments, the pharmacies collect the s… 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. Now, the question is what you can do with all this information. How well does your drug treat the disease it was prescribed for? She has over 25 years of experience in nursing, focusing most of her career in oncology. 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. 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. deliver comprehensive data that’s pulled directly from patients’ electronic health records. What side effects or adverse events are patients experiencing with your drug? Those factors can be other drugs, social determinants of health, other medical conditions, unknown or unmitigated side effects, and time on therapy. In this blog post, Iâll show you how to use specialty pharmacy data to ensure your therapyâs clinical and financial success. 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. 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. What is the average co-pay a patient experiences? MedicoRx® Specialty Pharmacy is licensed in the state of California. What are the reasons when patients discontinue your therapy? 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. DATA FIELDS The database, with 1,000+ pharmacy locations, updates its … Ever since electronic health records were mandated, in 2004, the industry has dreamed of rich, structured, and minable digital data sets. Setting quality benchmarks incentivizes providers to optimize treatment regimens and strategies to achieve the best possible patient outcomes. The ability to collect and aggregate data is essential for success in specialty pharmacy. But as a catch-22, the high volume of data can become overwhelming if it’s not harnessed and organized. A standardized approach to documenting, storing, reporting, and exchanging specialty data would provide great benefits to all stakeholders in this high cost marketplace. Click here to contact the team at DocStation. Data have a major impact on the industry for clinical and business reasons. These buyers want the best outcomes for the lowest cost. Value sets provide a subset of standardized data elements needed for reporting and exchanging clinical information. And better outcomes strengthen your relationship with prescribers and build brand loyalty to your drug and your biopharma company. 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. Samm Anderegg, Pharm.D., MSCEO | DocStation. Determine if a specialty pharmacy needs to reposition as centers of excellence in key areas of practice. What is the payer mix of the patient population taking your drug? 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. For prescribers, the value is outcomes, and outcomes depend on adherence. In a session presented by Pharmacy Times Continuing Education™ at the Asembia […] NCPDP has a specialty pharmacy workgroup to discuss common interests and construct a consensus-driven data management strategy for specialty pharmacy. You can also check out related stories in our publication, The Pharmacy Standard. 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. Pharmacies use clinical assessments to guide their talks with patients, which is also one of the main ways they collect data. It could be side effects, which pharmacies can help control. Specialty pharmacy describes high-cost, high-touch medication for complex diseases. You can also share it with providers who treat patients suffering from that disease. 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. These pharmacists treat those with cancer, multiple sclerosis (MS), autoimmune diseases, and other chronic conditions. Disparate data is accumulated from multiple sources, including payer claims, sales records, electronic medical records, pharmacy information systems, and data aggregators. . Insights from your specialty pharmacy information. Published Online: Wednesday, Jul 25, 2018. SPECIAL NOTE: Patients with hearing impairments may choose to communicate with our staff via a National TTY-TTD telephone line at 711. 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. Our Specialty Pharmacy Analytics and SP Scorecards diagnose performance and identify actionable coaching opportunities. specialty pharmacy and delivered to their home. The data aggregator de-identifies the information and can then send it to your biopharma company. High cost pharmaceutical products are dispensed by specialty pharmacies to treat complex and often rare disease states. Pharmacists may also identify tools in the EHR that they can put to use in the specialty ph… It could be pill fatigue, which pharmacies could relieve through counseling. As a trusted specialty pharmacy provider, we are focused on assisting patients, families and caregivers through the complex healthcare maze of … 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. This data can be provided by phone, by email and by text. How many times do your patients go to the hospital or emergency department? 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. Several industry groups are identifying clinical data elements for common specialty pharmacy disease states, including hepatitis C, rheumatoid arthritis, and multiple sclerosis. Pharmacy benefit management — working with employers, health plans companies and government programs — dominate the specialty pharmacy market in the United States since at 2008. If it performs better than a competing drug for the same disease, thatâs information you can share with patients through advertising. All these options bring advantages and challenges. Analytic value. Better adherence leads to better outcomes. By mining patient-level outcomes data, a Specialty Pharmacy can analyze the efficacy and safety profile of a specific treatment. 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. 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. Puerto Rico requires first-fill prescriptions to be transmitted directly to the dispensing specialty pharmacy. How are patients responding to your drug? Update: Many of these initiatives are now underway. The data flags the causes of nonadherence and points you to a solution. In this situation, data on hospitalizations and emergency department visits can be useful to your biopharma company. What other medical conditions do your patients have? The following are proposed actions for the specialty pharmacy industry. Today's specialty products require a litany of complex processes to create the optimal commercial strategy. This would provide a true solution for population health analytics and value-based reimbursement. Enjoy this post? meaningful use). All communications via that telephone line are confidential and compliant with FCC confidentiality guidelines. Ann Steagall is Director of Clinical Policy at Biologics. How adherent are your patients to your drug? Letâs say your drug and a competing drug produce the same outcomes. Lower hospitalization and emergency visit rates mean lower long-term costs for patients on your medication. Directly accessible data for 170 industries from 50 countries and over 1 Mio. The use of big data is by no means a new phenomenon in health care. ... Cigna's Accredo/Freedom Fertility revenue accounted for 20 percent of all Rx specialty pharmacy … Maybe the efficacy of your drug peaks after a certain amount of time. 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. 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. Click here if you can’t see the video below. Manufacturers, payers, and specialty pharmacies would benefit greatly from a robust data infrastructure allowing cleaner and faster reporting to stakeholders. Other sectors of the health care system can follow this framework to leverage health data. 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. 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. Many companies do not report prescription revenues from specialty drugs. There are data capture points within those conversations and these assessments are customized to match each disease and drug. 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 pharmacy evaluation and defining service-level agreements. 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. 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 … Accreditation agencies should align data requirement with standards developed by NCPDP and other SDOs. And he stressed the need to work with a pharmacy that has great data collection and reporting capabilities. 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. Strengthen your drugâs therapeutic value. 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 Discontinuation data is also important from a commercialization and brand strategy standpoint. Here are four ways you can use this data for your benefit. This data can be provided by phone, by email and by text. Pharmas who understand data and can make intelligent, meaningful data connections have a competitive edge. Specialty pharmacy is a unique and complex sector of the health care industry. Being diagnosed with a complex disease can be overwhelming. With specialty pharmacy data complexity communicate with our staff via a National TTY-TTD telephone are. Interests and construct a consensus-driven data management strategy for specialty pharmacy published Online: Wednesday, Jul 25 2018. 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