/publications/issue/2011/December2011/Low-Molecular-Weight-Heparins-Can-Be-Heavy-Hitters-

Low-Molecular-Weight Heparins Can Be "Heavy" Hitters

Author: David M. Suchanek, RPh

Is a low-molecular-weight heparin program right for your pharmacy?


The industry has come a long way in the treatment and prophylaxis of thrombosis. As the population ages and waistlines increase, so do the comorbidities that are often associated with acute and maintenance anticoagulation therapy. For years, pharmacies have worked hand-inhand with physicians in the management of the complex treatments and stabilization of patient-specific regimens.

As usual, with complexity there is opportunity for pharmacists to play a more active role in the improvement of patient outcomes. There is also an increasing business opportunity for those who invest the time required to develop a “LMWH program.” So why is this a business opportunity for your pharmacy?

First, some product needs are best serviced “locally.” Low-molecular-weight heparins (LMWHs) clearly fit into this category. If a patient is getting released from the hospital on a Friday night, can a traditional mail order pharmacy provide STAT delivery of product? Not easily. Can a specialty mail order pharmacy provide STAT delivery of product? Yes, but not easily and not without high internal costs.

A Business Opportunity

Which leads us to the second reason why it is a business opportunity: this category is typically not a focus of mail order pharmacies (or the PBMs that often own the specialty or mail order pharmacies). It is fairly easy to adjudicate the pharmacy claim and get an override if needed, due to the STAT nature of the product(s).

So where are patients to go when they are released from the hospital? Sometimes the hospital may have an outpatient pharmacy where the patient can obtain product, but not always, and they often have very limited hours of operation. This leaves many patients without a convenient solution. They might need to call multiple pharmacies to find the product in stock.

Questions to Ask

Be the solution for patients in your area. Talk to the local hospitals—what are their protocols for discharging patients who require anticoagulation therapy? Do patients receive a “dose” before leaving? Do they walk out with a prescription in hand? Does the hospital provide a listing of local pharmacies that carry inventory regularly? What products are on formulary in the hospital? Does the hospital have an anticoagulation clinic?

How can you work together with the clinic to provide continuity of care and enhance patient outcomes? Who are the top prescribing physicians in the area? Who is affiliated with the hospital/IDN? Would the hospital be willing to partner if you can assure them after-hours care and access to on-hand inventory of all the products?

Consider investing in the development of a hospital-specific/physician-specific Rx referral form with the relevant therapies listed. Develop a visual process flow. Develop a brochure characterizing your services. And dedicate an 800 number to your program, with access to a pharmacist or nurse after hours 24/7/365. A little investment of time and effort will yield increased revenue and, importantly, will differentiate your pharmacy from the rest of the pack. PT 


David M. Suchanek, RPh, is senior vice president of biotech and specialty services at D2 Pharma Consulting, LLC, a consulting firm which focuses exclusively on pharma services in the life sciences industry. Mr. Suchanek is a member of the Specialty Pharmacy Times editorial board. For more information, visit www. SpecialtyPharmacyTimes.com.