Regardless of the ability to access and dispense products, pharmacists are responsible for getting patients the best care.
With increasing complexities in medication access, partnerships between health-systems and manufacturers could help minimize roadblocks in patient care, according to a session at the Asembia 2022 Specialty Pharmacy Summit.
Rapid progressions in medicine have sparked evolution in the channel and payer markets, according to presenter Jacob Jolly, PharmD, principal consultant at Blue Finn Group. However, these evolutions have also complicated access to some medications, including prior authorizations, shipping and storage challenges, supply chain logistics, and REMS compliance.
Panelist Cheryl Allen, BSPharm, MBA, founding partner of C. Allen & Associates and executive vice president, Business Development at the Specialty Pharmacy Nursing Network, reviewed some significant new therapies that have come with unique challenges. For example, tebentafusp-tebn (Kimmtrak; Immunocore) is an infused product for patients with uveal melanoma. It costs approximately $400,000 per patient per year and is a titrated dose over time. Notably, the first 3 doses require 16 hours of monitoring due to high rates of cytokine release syndrome in clinical trials, making access and administration a challenge.
Chimeric antigen receptor (CAR) T-cell therapies also have unique requirements, including complex orchestration platforms to support all of the logistics and benefit information, patient information, and more that is required. Allen emphasized that manufacturers are entrusted with patients’ cells when working on CAR T-cell therapies, so the entirety of the orchestration platform must be optimized to support that process.
Jolly noted that health-system pharmacies maintain accountability for the entire patient journey. This responsibility underpins the unique capabilities of health-systems and the fundamental ability to coordinate care and communicate via the electronic medical record.
Panelist John Robicsek, MBA, associate vice president of strategy and business and program development at Atrium Health, agreed, adding that hospitals are continuing to challenge pharmacies with more tasks and responsibilities. Every new drug also presents new challenges, he said, and focusing on patient affordability is an important piece of the puzzle that cannot be forgotten.
“They are looking to us to make sure that they can reach their outcomes and affordability is becoming much more of a role in that,” Robicsek said.
Allen noted that shifting sites of care also play a role in affordability, with the impact of these changes landing directly on patients. Payers are increasingly expanding site-of-care policies to find the least expensive site of care, which could be outpatient or even in-home settings.
Finally, the panelists said there are several great opportunities for manufacturers to partner with health-systems in managing these market complexities. Panelist Elizabeth Cherry, PharmD, MMHC, CSP, program director of specialty pharmacy trade relations at Vanderbilt University Specialty Pharmacy, said helping manufacturers identify patients who are appropriate for novel treatments is a great chance for a partnership.
Collaborating on monitoring decisions and using the full breadth of data available to pharmacists could also help optimize treatment and remove obstacles.
Robicsek emphasized that these collaborations should not be decided solely on the basis of what is in or out of network. Ultimately, regardless of the ability to access and dispense products, pharmacists are responsible for getting patients the best care.
He concluded that it is important for manufacturers to engage with health-systems, regardless of network status, to further the shared goal of improving patient care and outcomes.
Allen C, Cherry E, Robicsek J, and Jolly J. Breakthrough Innovations in Drug Treatments Demand Equal Attention to Optimize Patient Care. May 4, 2022. Presented at Asembia 2022 Specialty Pharmacy Summit.