Specialty Pharmacy: An Industry at Warp Speed

No other industry is moving at this warp speed or reaching into so many new frontiers. Here's what one industry leader has to say about today's landscape and what needs to happen for the specialty pharmacy industry to continue to thrive.

No other industry is moving at our warp speed, and no other industry is reaching into so many new frontiers. There are a lot of areas impacting the future of specialty pharmacy. I’m going to focus on 2 areas that are critical to the future success of our business—outcomes and technology.

OUTCOMES

For the specialty pharmacy industry to continue to thrive our business must be equally driven by both drug and servicerelated components. These 2 components need to be tied to outcomes at a level we have either been unable, or unwilling, to meet in the past. We need to ask ourselves, how can we become better partners to our stakeholders— pharma, payers, pharmacy benefit managers (PBMs), etc, while improving services to our patients and always looking to enhance outcomes? Drug distribution and services must be defined, separated, and developed so specialty pharmacies can be better partners.

We’ve come a long way from our father’s pharmacy; however; what remains the same is that we still touch patients’ lives on a regular basis and have an incredible impact on their health and well-being. When it comes to health care, as pharmacies, we are still the most frequent access point to this day.

HARVESTING THE PATIENT INTERFACE

We touch patients on average at least 12 to 15 times a year. We are in the driver’s seat. Yet, as an industry we’ve just scratched the surface of what we can deliver in terms of outcomes once we truly embrace technology. In order to continue providing a high level of touch, in a technology-driven world, we must harvest data from the patient interface. Harvesting data from multiple directions such as viral loads, disease progression, or quality of life surveys will improve our ability to deliver complex therapies and enhanced outcomes efficiently and economically to meet not only our patients’ needs, but also those of our business partners.

Harvesting of the patient interface is the leading edge of pharmacy practice. How often have you heard or said, “It’s all about the data.” As we better understand how to manage and extract data, our interactions with patients can be done more economically, with greater results and with a new focus on outcomes.

In the future, we should be thinking about managing patients even though we may not always be dispensing the drugs. We need to protect our space—great opportunities are here—but we need to make sure we are not dispensers only. Delivery of medication is an important part of what we do, but the minute it becomes all we do we will cease to grow as an industry.

When Diplomat created a proprietary patient care program called eNAV, all we had to do was give a demonstration and we would often win the business. That’s not the case today. Now we have to create new tools to deliver outcomes reporting. Delivery of clinical management still falls on technology to quantify and measure. It’s true what they say: “If you can’t measure it, you can’t manage it.” Outcomes is driving the paradigm. We need to identify the services we can deliver in the future that will have the greatest impact. This is how we will create sustainability.

DELIVERING TRADITIONAL PATIENT-CENTERED CARE IN A HIGH-TECH WORLD

We are part of a cultural journey, and our business of specialty pharmacy must recognize the changing technology. Change is always around us, but nowhere is it accelerating faster than in technology and no area can take you out of competition quicker. We constantly need to assess and get at the core of what our patients and business partners really need. I like to use the example of recorded music. Vinyl records gave us music, but not portability. The Walkman gave us music and portability, but not a custom playlist. Today’s technology gives us music portability and a custom playlist. Specialty pharmacy needs to provide a custom playlist, a targeted a la carte menu of patient services to meet specific needs. Medication possession ratios (MPRs) are still the best validations today, but will they meet the needs of the future?

HEALTH INFORMATION TECHNOLOGY

Health Information Technology (HIT) is one of the fastest growing sectors in all health care, with some of the highest demand for all levels of talent (executives, data architects, programmers), and finding good people can be a challenge.

As a company, you have to ask yourself, what do you need to do and where do you need to go to become a business intelligence driven company? Can you do it alone or do you need to partner with technology companies to take your game to the next level? At Diplomat, based on our ongoing analysis and the rapidly changing health and technology landscape, we are using outside partners to drive and expand our HIT capabilities.

The needs and the complexity of our industry are both growing. As technology is evolving, the future winners will have the answer to predictive Health Business Intelligence (HBI). At Diplomat, our highest priority is in the technology infrastructure that will sustain our future.

BETTER, FASTER, CHEAPER

Health Business Intelligence makes it possible for health care providers to better manage comprehensive patient care through the secure exchange (across systems) and sharing of health information. Technology must have the capability to support an integrated health information exchange to continue the cycle of care. HBI is increasingly viewed as the most promising tool for improving the overall quality, safety, and efficiency of the health delivery system. Using HIT, specialty pharmacy can reduce and prevent medical errors, reduce health care costs, and increase administrative efficiencies.

SELF-SERVICE HEALTH CARE DRIVES EMPOWERMENT

Consumers have a growing interest in Information Technology to improve their own health in a culture dominated by data-on-demand. Instead of building technology, we want to look at the technology that is being adopted today to see how the health care environment can take advantage of it. If we engage the patient in their own patient care, through established channels, we have a much better opportunity to ensure compliance and adherence. Social media, mobile, web, and e-mail are tools driving consumer engagement to make real-world impact.

These vehicles present opportunities to provide patients with meaningful information to make an educated choice about their health by engaging in channels most useful to them. Online communities are evolving from simple support mechanisms to becoming personalized platforms.

Further, social reinforcement is providing the necessary piece to help the patient change their behavior and stay engaged.

HEALTH DATA: SINGLE SOURCE OF TRUTH

Historically, health care data have largely been brought to us by researchers through questions of “What works?” This provides guidance, but breaks down when we need more granular data. Providers are increasingly pressed to demonstrate value in terms of reduced complications, improved outcomes, and evidence-based care. This accountability is driving a greater reliance on data— requiring the health care industry to collect, scrub, and perform the necessary mining. Further, data drives decision in both identifying and enabling the pursuit of business opportunities (or problems), through reporting, analysis, statistical modeling, and predictive analytics. Even more, business intelligence aligns data, staff, and tools with corporate goals and business units to meet their respective needs.

There have never been greater opportunities around us in specialty pharmacy, but the landscape is ever changing. I believe those that invest in change and in the technology to deliver it will emerge as the industry leaders of the future.

Phil Hagerman, RPh, is the chief executive officer of Diplomat Specialty Pharmacy, which he founded with his father, Dale Hagerman, in 1975. He has been a regular speaker at state and national pharmacy and hospice conferences on practicing creative pharmacy and developing and marketing a specialty pharmacy practice. He has led the company’s tremendous growth period, and in 2009 and 2010, Diplomat was named as one of Inc. Magazine’s fastest growing private companies in America. This article is based on Mr. Hagerman’s recent presentation at the Armada Specialty Pharmacy Conference held in Las Vegas.