Insights

Practical steps to establish or expand your program – and achieve results.

Health systems are beginning to discover that building an internally run specialty pharmacy can be a win-win situation for both patients and for the organization. How? Because specialty pharmacies can improve patient satisfaction and quality of care while also serving as a new source of revenue.

This win-win scenario is becoming increasingly attractive for many health systems looking to manage their bottom line in uncertain economic times. But successful specialty pharmacies come in many shapes and sizes. So, what’s the common thread that leads to an effective program?

As a partner that’s helped many health systems build their own specialty pharmacies, Visante has identified five time-tested keys to success.

Involve your key stakeholders.

One of the biggest mistakes we see many organizations make is underestimating the level of support they’ll need from different stakeholders throughout their journey to build a specialty pharmacy. Whether it’s your managed care team, compliance and accreditation teams, IT and tech services, or legal, these people will be helping you navigate the marketplace and meet specific program needs.  

Even if those stakeholders won’t be heavily involved in the early stages of your journey, you’ll likely rely on them at some point along the way. So, it’s best to reach out early to make them aware of your plans and their role in helping to drive the program’s success.

Focus your initial efforts on the three Ps.

Building a specialty pharmacy from scratch can be a complex and intimidating process. That’s why we recommend starting with a simplified approach that focuses on those areas where access already exists for your health system. We call this the “3Ps approach,” and it enables you to get your program off the ground first before diving into broader access with payer and manufacturer negotiations.

• Access to the prescription – in a health system environment, you have prescription access from your care providers and the clinic, so you’ve already got a leg up on the competition!
• Access to the product – this is your ability to purchase the product from your wholesalers or manufacturers to fill within your pharmacies.
• Access to the payer network – this is your ability to dispense for your patient and get reimbursed for the services you’re providing to them.

Determine investment needs and barriers to marketplace entry.

For all their valuable benefits, specialty pharmacies can also pose some challenges. So, it’s important to define what additional investments will be required, and any barriers you’ll need to overcome. Investment needs may include storage space, equipment to keep drugs at the proper temperature, and staff to handle prior authorization work as well as dispensation and clinical services.   

Even for organizations that don’t currently have outpatient pharmacy services, we often see a profitable operation within the first year, as there is significant value gained in filling these prescriptions internally.  

Know when to ask for help.

It’s important to know your own limitations – and to understand when you need help. Building a specialty pharmacy can be a daunting task. But qualified partners with deep expertise in this area, such as Visante, can make it easier to navigate the process and help you avoid common pitfalls.

If the complexities of your specialty pharmacy journey have left you feeling overwhelmed or unclear about how to get started, it’s wise to step up and ask for assistance. Engaging additional support may be exactly what’s needed to quickly get your program from launch to the finish line.

Remember that small steps can yield big results.

When it comes to building out your specialty pharmacy, we recommend starting small. In fact, many of our clients begin with just a single clinic – or even with just one specific patient population within that clinic. Why? Because it’s a way to achieve small wins that help to build the program gradually over a six to 12-month period.

We often see those small wins catch on like wildfire in the organization. They’re a great way to boost momentum and excitement, while giving you the ability to manage the program’s rate of growth based on your current resources.

At Visante, we believe that an internal specialty pharmacy business model is best for patients and health systems. Our expertise helps clients quickly grow and sustain strong performance, with many clients experiencing at least a 10:1 ROI through our partnership. Email solutions@visanteinc.com or call (866) 388-7583 to speak to one of our team members.