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Bridging the gap between the hospital and alternate-site care
Volume 1 • Number 3 • Summer 2012
specialtypharmacycontinuum.com
In This Issue Ask the Expert
4
The benefits of URAC accreditation.
Operations & Mgmt
6
New global drug registry may boost supply-chain safety.
7
Tips for weathering specialty drug recalls and shortages.
Policy
12
Proper coding, patient intake key to infusion reimbursement.
14
340B drug discount program a $6 billion market force.
Clinical
18
Walgreens Specialty Pharmacy’s approach to multiple sclerosis management.
21
New data support tadalafil for pediatric pulmonary arterial hypertension.
BUYER’S GUIDE See insert after page 6.
Carving a Specialty Niche Within the ACO Model Las Vegas V —Specialtty pharmacies can play a central rolee in improving health outcomes and reducing costs as the health care syystem continues to shift to an acco ountable care model, Diplomat Speccialty Pharmacy CEO Philip Haggerman, RPh, told attendees off the annual Armada Speciaalty Pharmacy Summit. Mr. Hagerman urged specialty pharmacies to provide value-added services and invest in technological infrastructure and up-to-date edu-cation and training to t position themselves as key players in an acccountable care environment.. “The new paradigm w will be challenging but will also prresent many opportunities,” said M Mr. Hagerman, who delivered a state-of-thes industry address at th he Summit. “We are crossing over from what used to be a siloed approach to patient care and, as we do d this, we want to make sure we meet our o partners’ needs by optimizing outcomes and costs.” The Accountable Caare Act provides the conceptual framework for an accountable care model, with the imperative to work collectively, but Mr. Hagerman said it does not spell out a “formula to achieve the efficiencies that it’s aiming for.” The onus to demonstrate these efficiencies and to provide outcomes data is on the individual pharmacy, said Stephanie S. Holliday, PharmD, the director of clinical program development at Prosperity Specialty Pharmacy, an AcariaHealth Company, in Falls Church, Virginia. “To maintain our position in a provider network, we need to show that our services and treatments are leading to both optimal therapeutic and financial outcomes,” Dr. Holliday told Specialty Pharmacy Continuum. “This means analyzing factors such as staff time spent on patients,
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see ACO MODEL, page 13
FDA Approval
Costs Driving Specialty Drug Pharm’s Future Scottsdale, Ariz.—A fast-growing number of Americans with cancer, multiple sclerosis (MS), HIV/AIDS and dozens of other illnesses are living longer, healthier lives thanks to specialty pharmaceuticals. It’s no surprise, however, that the significant benefits of these sophisticated medications come at a high price. Specialty pharmacists, pharmacy benefit management companies (PBMs) and payers are wrestling with the best way to provide these medications to patients who need them without breaking the bank. “The most important thing we need
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see DRIVING FORCE, page 5
Interferon Takes Hit in MS Study; Patient Fallout?
I
nterferon-β therapy did not produce a long-term reduction in the progression of disability among patients with relapsing-remitting multiple sclerosis (MS), according to a study in the Journal of the American Medical Association ( (2012;308:247-256 ). Based on the results, specialty pharmacists may need to manage patients’ expectations about interferon-β’s impact on the disease, experts suggest. Patients who are concerned by the widely publicized study findings also must be told not to stop complying with interferon-β
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see EFFICACY, Y page 21
The Book Page
Rayos approved for rheumatoid arthritis, other inflammatory conditions.
Pharmacy Management, Third Edition
See page 11.
See page 27.
By Shane Desselle, David Zgarrick, and Greg Alston