Health system specialty pharmacists today are likely to fill as many roles at their hospital as they do prescriptions. As advocates, communicators, and integrators, they connect patients to medications, services, and a continuum of care. As navigators, they fill another important role: surmounting obstacles to obtaining limited distribution drugs, accessing payer networks, and providing patients with the quality care they deserve.
Over the past decade, health systems have invested in specialty pharmacies at a growing rate. Despite this investment, health systems continue to face significant headwinds:
- Restricted access to limited distribution drugs
- Exclusive or narrow contracts that restrict payer networks
- Operational challenges
Restricted Access to Limited Distribution Drugs
Specialty drugs are difficult to obtain because manufacturers have limited their distribution to an increasingly small pool of providers. Why? To have greater visibility to the patient journey, collect required data, and optimize outcomes. The issue with limited distribution networks is that they don’t always serve the best interest of patients. When hospitals, where patients are treated, can’t access the drugs they need, patient care may be compromised.
Exclusive Contracts that Restrict Payer Networks
The exclusive or narrow network contracts that many plan sponsors negotiate with PBMs may offer lower drug prices, but they often come with a serious downside: patient care fragmentation, higher prescription abandonment rates, and time-to-treatment delays. Many plan sponsors sign exclusive or limited network contracts with PBMs that offer lower rates in exchange for exclusivity. What plan sponsors may not consider is that beneficiaries may be restricted from using pharmacies in the medical centers where they are treated.
Whether it’s cold chain requirements, accreditation or data management, specialty pharmacies are complex. Building and maintaining an infrastructure is demanding work that requires expertise and detail orientation. From staffing to drug storage to hub services, every area of operation is integral to specialty pharmacy success.
So how do health system specialty pharmacies demonstrate to manufacturers, plan sponsors and payer networks that it’s in the best interest of patients to partner with providers who are on-site members of a care team? This is where Acentrus Specialty makes a difference, by connecting client health systems to these advantages:
- The power of a network
- Tools to educate decision-makers
- Best practices and valued vendors
The Power of a Network
Acentrus advocates on behalf of client health systems with manufacturers, drug wholesalers, and distributors. By showcasing our clients’ patient populations, accreditations, clinical capabilities, research activities, data management, and other assets, we can help you access the drugs your patients need so they benefit from the continuum of care post-discharge.
Tools to Educate Decision Makers
Acentrus helps client health systems educate human resource departments and other decision-makers about the importance of negotiating payer contracts that give patients latitude in choosing a pharmacy. By demonstrating the value of less restrictive payer networks, we help your patients choose what is best for them.
Best Practices and Valued Vendors
Acentrus Networking Groups connect clients through a network designed to share best practices and build a brain trust of like-minded organizations. Contracts with channel partners and other vendors provide clients with the resources they need to meet infrastructure and operational challenges.
In all of these ways, Acentrus brings our clients together in a network to advocate for better patient care. By leveraging the collective power of our client health systems and hospitals, we are working together to transform the specialty pharmacy space. For more information, visit Acentrusrx.com.