Heather Brand, PharmD, MSPBA

The rapid proliferation of specialty pharmacies has led to a growing need to create models that truly differentiate the various offerings in the marketplace. Specialty medications now account for more than one-third of all spending on drugs in the United States. Furthermore, specialty drugs are well on their way to claiming more than 50% of this spend in the next 10 years. 

This growing trend has attracted myriad players to the specialty arena—insurers, pharmacy benefit managers, hospitals, retail drug stores, and even supermarkets have carved out niches within the marketplace to offer professional and focused pharmacy services to specialty patients.

The diversity of offerings has led to the demand for standardizations to ensure consistent and validated care to all patients. 

While accreditation has answered this need for payers and manufacturers in the past, there remains great disparity in the patient experience from one specialty pharmacy to the next. Accreditation often ensures that the mechanisms to service high touch patients holds a minimum level of quality and consistency from an overall health care performance perspective. Accreditations only lightly lend attention to the interface between the providers at a specialty pharmacy and the patient lives as they live in the community.  

This node of interaction can greatly impact overall outcomes as the patients either become drawn into a relationship that advances the goals of their care or alienated from a system that ultimately results in a commoditized dispensary service. Because effective and valuable patient interactions that result in coveted relationships can impact performance, persistence, and adherence, payers and manufacturers are seeking new ways to measure the capabilities of specialty pharmacies as they continue to develop and enhance their limited distribution and specialty networks. 

Specifically, the benchmarking of patient care experiences has emerged as an industry-wide initiative. Targeting the patient experience has led to a clearer understanding of the disparity that remains between specialty pharmacy providers who are designed and managed to efficiently provide medications in high volumes and specialty pharmacy providers who have truly dedicated their organizations to supporting and communicating with patients through their achievement of health goals. 

Patient satisfaction surveys are becoming an increasingly popular mechanism to measure a specialty pharmacy’s capabilities and services. Internally generated and administered surveys can validate core practices for specialty pharmacies while only accounting for a minimal financial investment for the organization. 

Satisfaction results can be utilized to identify points of deficiency and, correspondingly, to initiate quality improvement. Conversely, these same results can validate processes intended to drive performance towards coveted goals. Further, staff engagement surveys provide metrics that facilitate workforce improvement. 

Results enhance staff understanding of what their direct efforts translate into in terms of goal achievement and can be utilized to empower employees and increase efficiency. Such exposure can be deployed at all levels of a specialty pharmacy, giving every single team member a common understanding of what makes the organization, as a whole, successful.

Other findings from internally generated surveys can be leveraged to identify and initiate various operational refinement, such as communication and process improvement. While surveys produced and administered internally provide the benefit of offering an inexpensive means of measuring the patient-pharmacy experience and can be easily tailored to the individual pharmacy’s reporting needs, they fail to provide an unbiased and comparative analysis that allows a specialty pharmacy to truly differentiate itself in a meaningful way. 

Skepticism over skewed results or biased survey design can be eliminated with the use of a third-party administrator. Externally governed surveys advantageously provide a benchmark that a specialty pharmacy’s service can be measured against in order to compare key competitors within the industry.  

This benchmarking is of high importance to 2 major stakeholders—payers and manufacturers&mdash;who are increasingly turning to the patient experience to gauge the operational efficacy of specialty pharmacies as it pertains to creating meaningful change in patients’ lives. In an effort to develop network partnerships with the most robust and capable service providers, payers and manufacturers are hungry for the validation that third party mediated satisfaction surveys can provide. Although participation in a third party survey holds the risk of exposing weakness or deficiency, deployment of a validated survey provides an unbiased, trustworthy picture of how one particular specialty pharmacy stacks up against another.

Besides the advantage of utilizing third-party survey results to market a specialty pharmacy’s capabilities to a payer or manufacturer, the survey results can be used internally to drive process initiatives to either capitalize on points of excellence or correct deficiencies. As an added frame of reference, these metrics can also help to drive growth strategy for a specialty pharmacy provider (SPP) by permitting insight on how the volume versus service continuum is realized.  

Contractual obligations are emerging that require a specialty pharmacy provider engaged with a payer or manufacturer to perform surveys and share resulting data. Therefore, these tools are becoming not just useful, but necessary in many instances.

Irrespective of the mechanism by which a specialty pharmacy chooses to administer satisfaction surveys, they are growing in importance and utilization regardless of what lens you are viewing them from. Looking at the survey from a marketing or sales point of view, it is clear to see the importance of being able to present performance achievement that is quantitative and comparable. 

However, surveys are increasingly important from a quality perspective as a growing number of contractual agreements with payers and manufacturers have patient satisfaction metrics built into them. In this regard, compliance with contract terms is dependent on producing and obtaining survey results.

Specialty pharmacy providers (SPP) are gaining valuable metrics through 

. These surveys can be deployed by the SPP itself or via a third party mediator. Utilizing a common service that positions the mediator between multiple SPPs can carry risks, but the benefits of the resulting data can far outweigh this.  

From marketing efforts to quality assurance programs, and from contractual obligations to process validation, these surveys are finding highly varied, highly valued niches of utilization internally and externally for any given SPP. Industry partners are also increasingly interested in these services as a means to evaluate network design from both payer and manufacturer points of interest.  

Taking all these factors into account, it can be expected that the marketplace will see an increasing number of mediators, more in depth data set designs, a growing base of comparative data, and more critical uptake by partners. Patient satisfaction surveys in their evolution are not just here, but they are here to stay with increasing value and consumption. Pay close attention to this discipline, as it will allow you to pay close attention to your organization.

Heather Brand earned her BA in Chemistry and PharmD from the University at Buffalo, SUNY. She worked for an oncology based pharmacy for six years prior to transitioning to a consultant role for a benefits management firm. She is currently employed by Onco360 pharmacy as a Clinical Oncology Pharmacist and has just completed her Masters of Science in Pharmacy Business Administration (MSPBA), a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines at the University of Pittsburgh.

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A growing number of specialty pharmacy contractual agreements with payers and manufacturers have patient satisfaction metrics built in.
