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.
Related: Learn more about Studiomaca’s consulting and technology services for health system pharmacies