Expert: Using Pathways in Specialty Pharmacy Prescribing Can Support Greater Predictability in Drug Spend, Inventory


As best practices are established throughout the specialty pharmacy’s entire network, better patient outcomes become possible.

There are many ways for specialty pharmacies to create alignment with a health system or hospital to leverage its unique attributes in order to support patient access and outcomes, explained Ryan Haumschild, PharmD, MS, MBA, director of pharmacy at Emory Healthcare and Winship Cancer Institute, in a presentation at the American Society of Health-System Pharmacists 2022 Summer Meeting.

“We can leverage best practices from all of our locations and create better access for regional influence for certain medications with a number of providers for prescriptions that are being utilized,” Haumschild said. “We want to engage employers not only to leverage them to get access to medications to get coverage from our payers, but also at the same time to incorporate quality of life and patient-reported outcome data while we’re selecting different therapies from the clinic side.”

Haumschild noted that the implementation of clinical research conducted on site can also help to support innovation and ensure the specialty pharmacy remains at the cutting edge of treatment protocols. Further, this approach can help to create robust pathways that can add value for cancer center affiliates to support their ability to follow the specialty pharmacy’s established pathways in their prescribing habits.

From there, Haumschild noted it’s important to make sure that specialty pharmacy pathways align with local internal payers and external payers to ensure better coverage decisions and determinations.

“When we’re prescribing medications that we’re not constantly appealing, we’re making better, faster time to treatment for our patients,” Haumschild said.

Using these pathways also allows specialty pharmacists to use stronger data internally to drive decision making for the organization. As the specialty pharmacy acquires more hospital and community practices, they are able to use the pathways to better adapt to the specialty pharmacy’s prescribing habits because the data are already available to them in the electronic medical record; this then facilitates an easier and faster process.

Additionally, Haumschild noted that as best practices are established throughout the specialty pharmacy’s entire network, better patient outcomes become possible. Further, to get to that point, establishing shared decision-making processes is also critical.

“We know that evidence-based care is important, not just for the university campus, but even that community clinic 33 miles away. So we do that to leverage best practices in a consensus from a bunch of providers,” Haumschild said. “That means we pull in faculty and community providers to have shared decision of what treatment should be utilized by line of therapy and specialty disease state. That way, we know there’s more of a consistent practice, and we know that we have predictable outcomes across the site.”

This level of predictability can help specialty pharmacists to support greater utilization management practices and track which medications are most commonly prescribed. With this data available to them, specialty pharmacists can then better negotiate with manufacturers around contracts in order to get the best price possible, as well as support a greater level of access to the medications that are the most commonly prescribed.

With greater predictability around drug spend, specialty pharmacists can also support greater predictability around inventory. Haumschild noted that this level of predictability around drug spend and inventory is helpful when specialty pharmacists are looking to manage cash and cash equivalence for their organization.


Haumschild R. The Pathway to Success: Use of Pathways in Specialty Pharmacy Prescribing. Presented at: ASHP Summer Meeting 2022; June 13, 2022; Phoenix, AZ.

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