NASP/SPAARx Leadership Outline Benefits of Newly Merged Organization

Combined specialty pharmacy organization poised to advance the field amid changing health care landscape.

The field of specialty pharmacy experienced a massive shift on July 24, 2014, when the National Association of Specialty Pharmacy (NASP) and the Specialty Pharmacy Association of America (SPAARx) merged to create the largest professional and trade association in specialty pharmacy.

The merger of SPAARx, founded by Armada Health Care CEO Lawrence Irene, and NASP, founded by Gary M. Cohen, BSPharm, RPh, created a unified organization to face the growth and hurdles predicted to impact specialty pharmacy in the nation’s post-Affordable Care Act (ACA) environment.

The merged NASP/SPAARx group is expected to settle on a new name for the combined organization following the NASP 2014 Meeting and Exposition, which will be held in Orlando, Florida, from September 30, 2014, to October 3, 2014.

Significant credit for the merger was given to board members from both the NASP and SPAARx, though Cohen specially highlighted the work of NASP board member Burt Zweigenhaft, whom he called an ambassador for the deal and a crucial force in bringing the merger to fruition.

In anticipation of the major NASP meeting and expo, Specialty Pharmacy Times.com interviewed Armada Chief Strategy Officer Thomas Cohn, MS; Armada Business Development Director Chris Benz; NASP Vice President of Marketing and Communications Kathleen Wolff; NASP Chief Operating Officer Bob Fulcher, CAE; and NASP Executive Director James E. Smeeding, RPh, MBA.

SPT: What was the impetus for the merger between NASP and SPAARx?

Smeeding: Both NASP and SPAARx realized specialty pharmacy would be better served by a unified organization. We basically have the same goals and the same agenda. We think the industry needs one voice as a professional organization to address industry-wide issues, so the merger was pretty much the right thing to do.

Cohn: We’ve always felt that specialty pharmacy needs to define themselves before somebody else defines it for them. Really, the only way for specialty pharmacy to do that is to be unified. I think this is a great thing that helps us in that mission.

Wolff: Whenever you look at businesses that merge, you look for synergies. (NASP) has the education center—we founded the specialty pharmacy certification board—but we’re new. Armada founded SPAARx, which had a 10-year history and hosts a fabulous meeting in the Armada summit. People who have had a great experience there are loyal followers of the summit. So, they had all this trust and loyalty, and (being) combined with our education center, certification board, and the commitment we both share in terms of improving patient outcomes has to result in a fantastic collaboration that only makes sense. It will result in a highly effective synergy for the industry.

SPT: How can this unified group advance the field of specialty pharmacy?

Smeeding: The leadership of this industry sits on our combined boards. We also have payers and people like that on the board. As you look at things, generally speaking, the scope of collaboration will be extremely important to how we present ourselves to the industry as a whole. We think our combined organization is somewhat of a solution-oriented opportunity for all of specialty pharmacy, because we need strong support from manufacturers, payers, and patient advocacy groups.

SPAARx also started what I term special interest groups within their organization. Indeed, a pharmaceutical manufacturer has a different perspective than a payer, and a chain drug store has a different perspective than an independent pharmacy, and so forth. So, we’re very excited to bring those SPAARx-oriented interest groups together, because it’s really the membership that guides the industry.

We take a look at our membership and say we do have strong support from payers, manufacturers, and providers. There’s not a significant provider that isn’t associated with this combined organization. We’re very excited about the representation we have across the whole industry.

Cohn: From the Armada side, we’ve put control of our destiny in good hands. There was some overlap in the boards with some members who bring great perspective to the future organization. We’ve kind of separated ships, so the future lies in the board being able to put together what everyone is able to do as a combined group. I’m really looking forward to seeing what they can do together. There are a lot of challenges and a lot of opportunities to be a successful organization.

SPT: What are some of the benefits of having a unified voice representing the industry?

Cohn: I think the main benefit is that specialty pharmacy hasn’t been well understood by a lot of different stakeholder communities. Whether it’s patients, providers, or pharma, there are certain pockets of understanding. But, amongst a lot of people, there are gaps, and the best way to address this problem is to have all of us saying the same thing and not confusing anyone.

A lot of specialty pharmacies are new, so there is new terminology out there. Everyone uses different words in different ways. I think part of the opportunity of being together and having one unified voice is speaking the same language to start off with, being able to understand each other’s interests and goals, and being able to align together. In some cases, members of SPAARx are competitors, but not when it comes to bigger picture issues, and I think everyone understands that.

Smeeding: Our education center is being utilized as electives for some colleges of pharmacy where they don’t have the ability to get this kind of education. In the colleges around us, there is some confusion because they don’t orient towards specialty pharmacy. So, I think our orientation programs within colleges, higher education, professional organizations, and students will be priorities so people better understand the nature of this business and its critical impact on health care in the United States.

Fulcher: I think it’s important for this field—and it’s important for the health care system—to stand up and define itself to all stakeholder groups, and that’s why our group is so important. Education and collaboration with all stakeholders will be hallmarks of our new organization.

SPT: What can the merged group do to overcome the challenges currently facing specialty pharmacy?

Smeeding: We have a program in October where the whole object is to start a discourse. There are not too many places where a provider, payer, and manufacturer can come together and say, “If we’re really focusing on the patient, then we have to figure out some of these basics.” I think that’s a critical factor in terms of establishing the credibility and driving the outcomes associated with these high-cost, high-touch medications.

I can tell you right now, I think every organization interested in specialty pharmacy is looking to us to give that leadership. Not only are manufacturers saying, “Okay, there is now a single focus, and that’s an opportunity for us to develop these products to have with a better understanding of the marketplace in how these products are delivered, what the benefits are, what we can present to the American public, and what we can present to payers.” I think we can go reverse on that from the payer standpoint, what their expectations are, what the metrics are, and how they manage it.

It’s all about cost efficiency and it’s all about health outcomes. If we take a look at what’s going on under the ACA, where the government takes the lead in what happens from the private insurance side of the business, from our standpoint, this coming together all focusing around patients and the outcomes that we have to deliver is critical.

SPT: How can the merged organization help specialty pharmacy prepare for the impact of the ACA?

Benz: Certainly, we are in good hands with the NASP team and the structure we have built. Having a diverse board is a good thing, given so many different groups and interests. With the pharmacy benefit management interests, large chain interests, independent interests, health plan interests, as well as the manufacturer interests, we were always working on the same team when it came down to working for the patient. That is what specialty pharmacy is all about.

When it comes to influencing government, having one unified voice and working with local, regional, and national representation from SPAARx and NASP, as well as the representatives from companies on the board, it’s going to get more results on Capitol Hill. The ACA is viewed in many different lights, but more patients and more accessibility to health care is a good thing.

Fulcher: It’s never a disadvantage and is always a positive when advocacy takes place under one umbrella instead of 2. Policy makers and legislators are more likely to tune into specialty pharmacy when they are approached by the representative, rather than multiple groups that may confuse them.

I think it’s also important, given the increasing percentage of drug spending, that specialty pharmacy represents and the focus on patient outcomes, that payers, providers, and pharma have a place to go to align their perspectives and come together to assure the public and patients they serve that the products will be used in the most cost-effective way to achieve optimal patient outcomes. I think the new organization will provide that connecting point for all 3 groups.

Smeeding: There are things that happen that affect specialty pharmacy on a state and local level, and there are things happening on a national level, as well. There is nobody who does not have a stake in the in the game, as we point out the importance of spending in this area and development in this area. All of health care is looking for promises that we hope to be able to deliver.

The one thing about an organization that is collaboratively focused, as we are, is that people will have different perspectives that make our tutelage, our steerage, even more critical. We don’t expect that a payer is always going to agree with a manufacturer, nor that a provider is always going to agree that they’re being paid adequately. But, what we will find is that there is enough commonality of interest focused around producing value that we will do quite well.