Armada Speaker: Specialty Pharmacies Are at the Center of Emerging Health Care Trends

Author and consultant Myrtle Potter told attendees of the Armada Specialty Pharmacy Summit that specialty pharmacies need to demonstrate their value to capitalize on the changing health care environment.

Specialty pharmacies are expected to play a major role in the rapidly changing health care environment, according to leading health care consultant Myrtle Potter.

Potter, who was a featured speaker on May 7, 2014, at the annual Armada Health Care Specialty Pharmacy Summit and Expo in Las Vegas, is an author and CEO of Myrtle Potter & Co, LLC, a life sciences and health care consulting firm, and Myrtle Potter Media, Inc, a consumer health care content company. She has also served in executive positions for companies such as Bristol-Myers Squibb, Merck, and Genentech.

In her speech to a large crowd of specialty stakeholders at the Armada summit, Potter laid out 7 emerging trends in health care that will have a direct impact on the business of specialty pharmacy. Those trends are health care being provided in a wider variety of venues; an explosion in technology; a changing regulatory landscape; a shift to high-deductible health plans; increased consolidation in the health care industry; buyouts of independent practices; and movement toward a patient-centered health care system.

“I think your business is like a juggernaut,” Potter told the audience. “The question becomes what do you do with all the changes around you.”

Potter noted that the growth of retail clinics and accountable care organizations (ACOs) will directly impact the business of specialty pharmacy because pharmacies have abilities that touch on 4 quality metrics valued by ACOs. These abilities are: promoting good health, communicating with patients, maintaining patients’ health status, and maintaining patients’ connection to their physicians.

Potter stated that specialty pharmacies help keep patients out of the hospital through existing channels of communication that stress the importance of good health practices. To capitalize on the growth of ACOs, she noted, specialty pharmacies will need to demonstrate their value.

“I cannot see a world where your business doesn’t sit squarely within an ACO or doesn’t have a very tightly linked contract agreement with an ACO,” Potter said. “In order for you to be viewed as a valued partner for an ACO, you have to be able to prove that by working with you and working with your systems, these organizations can do better than by working with a retailer to help manage specialty patients.”

Potter pointed out that emerging technology will help improve adherence for specialty pharmacy patients, be it through text message medication reminders or digital sensors embedded in oral medications that can send usage information back to caregivers. Potter added that specialty pharmacies need to consider how they can connect to patients and provide access to available technological tools.

“If you have anyone in your organization right now whose job it is to think about technology in a way that engages patients, I would say this will be one of the most important things you can do because this is going to stay and will remain very powerful,” Potter said.

Specialty pharmacies also need to remain aware of the impact of the Affordable Care Act on coverage of specialty medications and the amount of out-of-pocket expenses incurred by patients.

“Post Affordable Care Act, patients taking specialty drugs are covered at lower rates than they would’ve been pre Affordable Care Act, and this is an issue many of our patients don’t understand,” Potter said. “We care because financial issues like this stand to put a patient off of their care plan.”

Potter noted how the shift to high-deductible health care plans by many employers has the potential to lead to reduced adherence and delayed or bypassed care due to high out-of-pocket costs.

Consolidation of health systems is also expected to force specialty pharmacies to clearly demonstrate the value they provide.

“This consolidation brings great potential for you,” Potter said. “You now have emerging different classes of customers that you serve. … The needs of these practices are going to be different. More importantly, you have to keep demonstrating the benefits you bring to drive an optimal outcome.”

Ultimately, due to changes brought about by the Affordable Care Act that prioritize patient satisfaction, Potter said the goal of making the health care system as manageable as possible for patients will place specialty pharmacies at the forefront of this regulatory shift due to their existing methods of patient engagement.

“When I think about this, I think about how valuable you are as the solution for so many of these changes we’re talking about,” she said. “You can leverage so much of the stuff you have already invested in and are using with new customers.”