The Unintended Side Effects of the Specialty Pharmacy Service Model

The evolution of specialty pharmacy has raised the stakes for the services that patients expect during treatment.

So, you read the title of this article and maybe it caught your attention, half-heartedly though. Before you even get to this point, you have already assumed where this might go. Most importantly though, you know that cost will drive this article...it has to doesn’t it?

There are 2 words in the article’s title that have shaped your assumptions and provoked your emotions—specialty pharmacy. Yet, if you reread the title now, there is a good chance that you will see something different. Do you see it? Excellent.

Let’s explore the specialty pharmacy service model together then.

What we know

We hear and talk a lot about specialty pharmacy today, or at least I do. It has changed the health care landscape forever and will continue to do so.

We know that specialty medications are expensive to manufacture and expensive to purchase across the entire spectrum. We also know that specialty medications utilized for the appropriate indication can change an individual’s life.

More of what we know

The vast majority of specialty medications must be dispensed by a specialty pharmacy. Beginning with a referral from a licensed prescriber, the specialty pharmacy must confirm stock of the medication.

Beyond this, the medication will most often require approval from the payer, be reviewed for clinical appropriateness by the pharmacist, and then contact must be made with the intended patient for coordination of care.

It is a laborious first step that can set the precedence of care through the eyes of a patient (important).

Even more of what we know

Once the patient receives their first delivery, the journey can vary greatly depending on the disease, the medication, and the patient. However, the service model embedded in specialty pharmacy practice is largely unchanged.

After the first dose of medication is administered, the patient will likely receive a follow up call from a pharmacist. It’s an opportunity for the patient to discuss adverse effects, tolerability, or ask a question.

Moreover, it is a performed service that affects the perception of a patient towards the specialty pharmacy they are being serviced by (important).

As the patient journey continues, one refill call after another, the service provided by the specialty pharmacy is continually reassessed by the patient. In time, the patient develops a level of satisfaction or dissatisfaction with their specialty pharmacy.

At this point, it is likely the patient can tell a story. A story about how their specialty pharmacy goes above and beyond to provide optimal care. Or, one that has been an indifferent, but adequate experience with their specialty pharmacy.

Regardless of the scenario, the service model (and not the medication) that provides the patient with their medication and optimizes their outcomes now defines the patient’s story about that specialty pharmacy—the unintended side effect.

We know how important it is for a specialty pharmacy to have a high-quality service model. It can mean the difference between obtaining a contract with a manufacturer or not.

It can mean the difference between obtaining accreditation or not. It can even have a bearing on payer contracts. So, how is this unintended when it appears to be more of a necessity?

The power of the “C” word

Consumerism. You have heard about it and you most likely have contributed to it, but not in specialty pharmacy.

There are a variety of formal definitions for consumerism, all of which are too advanced for this average Joe. When I think about consumerism though, the holidays come to mind, namely Black Friday and Christmas shopping.

I think about finding the product or service I want at the most affordable price possible. Or conversely, finding that splurge product or service that I want and taking the necessary action to ensure I get it.

Let’s use Apple’s iPhone for example. I have been a loyal user of this phone since the first generation. Quickly, it became a vital part of my everyday life.

Whether it was email, the internet, or movies all while being on the go, it changed how I went about things. I told everyone about my experiences—friends, family, even a stranger who would ask.

Every 2 years, Apple released a hardware upgrade for its iPhone. With that upgrade, came more and more possibilities. Having a personal desire to obtain those possibilities, I, along with millions of others, stayed up into the late hours of the morning to pre-order the next generation of the iPhone.

Apple successfully drew in millions of consumers. Collectively, we became accustomed to the product and the service that accompanied it. Simply, we could not get enough and wanted much more.

Had Apple deviated from their advancements of the product or outstanding service, many consumers would have been quick to share their story about it.

The “C” word and specialty pharmacy

In our world, we don’t necessarily think about the impact consumerism has on the business. Truthfully, we never really had to, however, today is different though.

The evolution of the specialty pharmacy service model has created an expectation for our patients. An expectation that they are more than just a delivery service.

An expectation to be serviced as if they are the only patient and an expectation that if you do not meet it, social media will remind you of it.

All of which form the basis of the unintended side effect—consumerism.

About the Author

Joe Thomas earned his Doctor of Pharmacy degree from Duquesne University and earned his Masters of Science in Pharmacy Business Administration (MSPBA) degree at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines. He has spent the past several years working across several specialty pharmacies, integrated in both staff and corporate experiences.