A Specialty Pharmacy does more than just fill prescriptions. These pharmacies serve members with complex or chronic conditions who need a higher level of medical care, including an array of therapies that are often not covered by their insurance providers or may be too expensive for them to afford alone (financial assistance).
It's not unknown that many people with chronic diseases like rheumatoid arthritis, psoriasis or Crohn’s disease are spending a fortune on medications. With the higher price of drugs, many people are now required to pay a substantial percentage out-of pocket. This can be especially burdensome for those on tight budgets or who have insurance that requires them to fulfill a major portion.
A copay assistance program is essentially what it sounds like: assistance with covering copay amounts. Manufacturers provide either a coupon or virtual debit card to help cover copays for your medication. The eligibility requirements for a copay assistance program vary, but generally anyone who has private health insurance is eligible to enroll. Copay assistance programs don’t exist for every medication on the market, but there are many available. You are most likely to find a copay assistance program if your medication is expensive and relatively new. The savings from using a copay assistance program can be substantial. Specialty Pharmacies provide essential guidance and help enroll you into these programs, helping you get your medication.
Therapeutic Clinical Excellence
There are five technical pillars to clinical excellence: (1) evidence-based thinking and practice, (2) professional and peer accreditation, (3) decision support systems, (4) effectiveness and efficiency, and (5) learning and risk management.
Evidence-Based Clinical Management
In order to receive the best clinical care, clinicians use evidence-based clinical management to support you through your patient journey. Evidence based clinical management is a systematic approach to disease management in which clinicians and other health care professionals use the best available scientific evidence from clinical research to help make decisions and manage your care.
An accreditation is an official process of assessing the performance of an entity by an independent third party organization who is an expert in a particular subject area. An accreditation allows an organization such as a specialty pharmacy, to demonstrate their ability to meet national standards for quality, accountability, regulatory requirements and customer care. It's an important way to ensure quality standards for a Specialty Pharmacy.
Decision Support Systems
A decision support system is a computerized system that gathers and analyzes data, synthesizing it to produce comprehensive information reports, thanks to industry 4.0. Using a decision support system in managed care not only improves the efficiency and speed of decision-making activities, but it also increases the capability of futuristic decision-making of the organization.
Effectiveness and Efficiency
How effective and efficient is your specialty pharmacy? A specialty pharmacy is not just a business, it's an integral part of your healthcare team. Specialty Pharmacies provide patients with the best and most up-to date care by providing them access to highly trained pharmacists who can help address their individual needs in areas such as prescription drugs, side effect management or chronic conditions.
The need for safety in all areas of health care has never been more pressing. It is essential that anything less than providing this basic expectation and demand would be met with criticism to improve patient outcomes.
Real-Time Data Access
When it comes down to patient assessments, observations and outcomes, using real-time data entry can be key for healthcare. Diverting adverse events are now possible for clinicians by using comprehensive surveillance with real-time data. Using internal case management systems, such as CarePath, captures every data point of the patient experience, thereby offering a robust data and reporting platform.