Top 5 Health System Pharmacy Trends for 2019
The New Year promises to be filled with new opportunities for your
health system pharmacy to better serve the clinical needs of your patients and
the business needs of your pharmacy and hospital.
Here are the top five trends we think will have the biggest impact on
your health system pharmacy in 2019.
In addition to revealing the top trends for this year, let me explain
why they’re important for your health system pharmacy and how best to address them
to produce the best possible outcomes for you and your patients.
1.
Specialty drug spend is growing
The number of specialty drugs entering the market will continue to grow
in 2019, along with the price of each new drug. Prescribers and patients will
expect a seamless experience that begins with your health system pharmacy. Your
system will expect you to procure them and have health plans reimburse you for
them. You need key relationships in place with specialty pharmacies as you will
not be able to procure and dispense limited specialty drugs.
Many of the new drugs are targeted for specific disease states. Sourcing
them can sometimes be difficult unless you’re part of a limited distribution
network. And if you’re not part of a limited distribution network or an
accredited specialty pharmacy, health plans may not reimburse you even if you
do dispense them. Either way, your health system pharmacy can still dispense 80
percent of the specialty drugs on the market, and health plans will pay for
them. Be sure to tell that to your prescribing practices, so you can get that
business and your patients can access those drugs. You also should consider
seeking accreditation as a specialty pharmacy from URAC.
2.
Next-door healthcare is on the rise
Digital tech and mobile apps are making pretty much anything available
to consumers at their fingertips. When they become patients, they expect
on-demand care. Those expectations will only grow in 2019, and it will be
important for your health system pharmacy to meet them.
You will need to do more than extend the hours at your outpatient
pharmacy. You will need to make it as easy as possible for patients to fill
their prescriptions and stay on their meds after they leave your system. That
could mean filling prescriptions at the health system or delivering drugs to
them at home. In addition, partnerships with local healthcare providers will
prove invaluable in maintaining consistent patient care and adherence. Engaging
patients though a mobile app to monitor adherence and communication should be
top of mind.
3.
Increased focus on 340B performance and compliance
The 340B drug discount program should continue to be top of mind for
your health system pharmacy. It’s an ongoing topic of discussion that we don’t
expect to die down in 2019. That’s what makes this trend important for your
pharmacy. You’re not sure what to do, because things can change at any time.
But an increased focus on 340B gives you a path to follow. Actually, it gives
you two paths to follow: performance and compliance.
Internally, you want to make the most of your 340B program to
help patients and your health system. That means continuously monitoring how
well your program is functioning and whether it’s meeting your program goals.
Externally, you need to focus on compliance by staying on top of any changes in
rules, audits and enforcement and then adjusting your program accordingly. You
must be able to demonstrate accountability, transparency and compliance at any
point in time.
4.
Tracking and managing data will optimize growth
Health system pharmacies are swimming in data, and I’m sure your
pharmacy is no different. I recently spoke with a health system pharmacist who
had to go to 17 different information systems to get the data he needed to make
intelligent decisions about appropriate drug use. Like him, your challenge in
2019 will be to make all your data more useful and actionable so you can make
better decisions for your patients. The first step in that process will be
making your data more accessible. One way is to connect all your health IT
systems through one common platform. Another way that may save time is to have
all of your data in one data mart and leverage B2B solutions that can pull that
data into easy to understand and actionable insights at your fingertips.
Once your data mart is in place, installing
an analytics program can pull the actionable information you need. It
will present that information in a way that helps you make more informed
clinical and business decisions for your patients.
5.
Public policy is driving greater transparency
The push for more transparency into the cost of healthcare services for
patients and payers picked up steam last year and will accelerate in 2019. This
push will come from political pressure, federal regulations, state laws and
healthcare consumerism. Proponents of transparency are focusing on drug prices,
and that will affect your health system pharmacy.
Health plans may want to know how much you’ll charge for a new specialty
drug before they agree to pay you for it. Prior authorization is critical.
You may want more transparency from manufacturers about drug shortages
or their plans to exit a market so you can plan alternative therapies. Many of
the drugs that are in short supply are life-saving medications. To avoid these
serious supply chain disruptions, many health systems are developing their own
solutions to procuring these drugs.
On the outpatient side, patients may want to know how much you’ll charge
them for a drug as they shop for the lowest price among you and new
competitors. The expectation of transparency will affect every relationship you
have with other healthcare stakeholders.
As we look ahead to a new year filled with new challenges, the one thing
that shouldn’t change is your commitment to providing the best possible care to
your patients. The key to converting the five trends that we’ve identified for
this year into opportunities is your patients. Doing what’s best for them each
and every time will surely make 2019 your most successful year ever.
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