The American Pharmacists’ Association notes that “with specialty-trained pharmacists as part of the collaborative care team, enhanced patient satisfaction has been documented with fewer complications in drug treatment; improved laboratory monitoring; reductions in unnecessary medications; and shorter hospital stays resulting in lower treatment costs.”
Specialty pharmacy is a growing channel for biologics and other specialty medications. Chain pharmacies, Pharmacy Benefits Managers (PBMs), Health Plans, and independent pharmacies are all offering dedicated specialty pharmacies. These facilities offer services designed specifically for patients taking complex specialty medications. Engaging with specialty pharmacies provides a tremendous opportunity to improve outcomes. By the same token, engaging with prescribers about specialty pharmacies and their services by utilizing the right mix of channels, timing, and messaging has the potential for great impact on patients and improvement of medication adherence.
ConnectiveRx recently conducted a Specialty Pharmacy Survey (n>200) on prescribers’ perceptions of specialty pharmacies and the unique services they offer. For this study, we focused on the prescribers of specialty medications in these three disease areas.
- Injectable biologics for cholesterol
- Oral biologics for hepatitis C
- Injectable biologics for rheumatoid arthritis
In this survey, the majority of prescribers—78%—believe that less than half of their patients’ specialty pharmacy scripts are being filled at specialty pharmacies. Almost 20% of respondents believe that none of these scripts are being filled by specialty pharmacies. In selecting the pharmacy of the patient’s choice when prescribing electronically, prescribers may be sending their scripts to pharmacies without dedicated support for specialty medications. So how can we better support prescribers of specialty medications? How can we help them to identify where their patients can access the added services and clinical expertise provided by specialty pharmacies?
Patients Need Help
In the survey, doctors reported that their patients need help from specialty pharmacies in many areas. Specific matters of concern include navigating insurance and financial assistance (74%); understanding how to administer medications (58%); managing side effects (49%); living with diseases (40%); and ensuring proper handling of meds (39%).
Only one chain specialty pharmacy consistently stood out when rated by prescribers in these particular service areas. However, for all other specialty pharmacies that were listed in the survey, prescribers did not rate highly (or were not well aware of) the service levels they provided for patients in these areas of greatest need.
We then asked prescribers whether their use of a specialty pharmacy would significantly increase if they knew more about the services offered by specialty pharmacies that their patient can use. More than 80% of prescribers indicated that their support would increase for specialty pharmacies that are offering strong assistance with sourcing financial aid, as well as those able to help with navigating eligibility and reimbursement information; medication counseling; communication of patient-reported medication issues; and disease counseling.
An Opportunity to Increase Selection
So it is clear that there is an opportunity to increase the selection of specialty pharmacies for appropriate patients who are written specialty prescriptions. But, in order to take full advantage of this prospect, prescribers first need to know more about the specific services that specialty pharmacies can make available to their patients. In related research, prescribers expressed a preference for receiving education about these services outside the patient consultation, for example, through email. Prescribers are looking for education on the service levels that specialty pharmacies delivered, details about patient satisfaction, medication adherence results, and other such elements that matter to prescribers and their patients.
We concluded that in order to facilitate specialty prescribing, it is also important to provide prescribers with on-screen prompts within the EMR workflow. These messages should be crafted to call attention to the key pieces of information that are commonly queried. Two-thirds of prescribers highlighted some sort of information gap when prescribing specialty medications. The major information gaps identified concerned formulary and coverage; requirements for obtaining prior authorization; information about whether the drug should be billed to the patient’s medical benefit or to their pharmacy benefit (if it is a prescriber-administered drug); and patient support services that are available from specific specialty pharmacies. Access to formulary position is especially important for prescribers with high exposure to value-based contracts.
Multichannel messaging is the most effective way to educate, motivate, and activate behavior:
- Prescriber communications with lengthy or complex content are best delivered via digital (email or mobile) communications. Our research indicates that prescribers prefer educational messaging to be sent to them outside the patient consultation, such as via email.
- Where information is concise, impactful and actionable—relating to many patients or directly to a specific patient, such as patient savings or services—messaging in the EMR can be the most effective choice. Our research indicates that prescribers are more likely to take action when reminded or prompted in real time within EMR workflow.
So how can you make the most of these learnings? Once the optimal channel is chosen, the key to making your messaging impactful is tailoring the content and the delivery to the prescriber’s distinctive mindset. Understanding these perspectives, and reflecting the prescribers’ expectations in your message, will ensure it has a positive impact on the their behavior.
So while each of the two types of communications is strong on its own, we believe the combination of these two vehicles is where you will achieve the optimal impact on, and benefit for, both prescribers and their patients. Informing prescribers outside the consultation about expertise in delivering patient service can help prescribers understand the tremendous value of specialty pharmacies—reminding prescribers in EMR workflow where they can access these services helps to ensure that their patients benefit.