The Name of the Game Is Value

Specialty Pharmacy Times, September/October 2016, Volume 7, Issue 5

After recent issues with drug pricing placed the entire pharma industry in the crosshairs of the media and government legislators, one of the most promising movements to hit the health care landscape became obscured. Value-based health care may finally be the solution guiding our country to sustainable health care, firmly planting the well-being of patients at the forefront, where it belongs.

This model has already been adopted on a large scale by some stakeholders who were able to set themselves apart as leaders in the field, whereas others simply followed along, unable to meet this challenge head-on. Make no mistake, transitioning to value-based care is no small feat.

The Cleveland Clinic has emerged as one of the trailblazers in this area by reducing lab costs and unnecessary procedures, helping to lower its expenses by $500 million in the first year alone, according to an article in The New York Times. As such leaders in the shift to value-based care separate themselves from the pack, specialty pharmacy is uniquely positioned to help achieve the goals of accountable care organizations. With proven methods to support patients on high-cost therapies, specialty pharmacies already have the mechanisms in place to ensure patients adhere to, and achieve optimal outcomes from, high-cost specialty medications.

As such, I strongly urge you to read the article this month by Specialty Pharmacy Times® board member Marc O’Connor, who notes that the gap between patients and prescribers is in need of significant repair in order to reach this adherence goal. Specialty pharmacy can serve as the conduit to bridge this divide.

This will require pharmacies to be prepared to allocate additional resources to ensure patient access, weaving through the prior authorization process while performing effective medication management to validate the high cost of drugs that constrain scarce health care resources. While we continue to work toward a solution to both enable the pharmaceutical industry to deliver affordable drugs and to get them into the hands of patients, it will take a collaborative effort by each member of the health care ecosystem—prescribers, providers, and payers—to ensure value-based care reaches its potential and to advance the care of patients with life-threatening diseases.

As always, thank you for reading.

Mike Hennessy, Sr

Chairman & CEO