Brandon Salke
Pharmacist in Charge, General Manager of Operations
Optime Care
Specialty Pharmacy Service Models
Complex service models are a tremendous burden on the health and wellbeing of patients with rare and orphan diseases. When multiple vendors are involved, everything slows down. For these patients, on-time delivery of their medications can be a matter of life and death. There’s simply no room for unnecessary delays.
Yet, those delays are common when the traditional, complex service model is applied to rare and orphan drugs. For example, consider how many people a patient interacts with at a typical specialty pharmacy. To get started on a medication, a patient might first get an intake call from an 800 number. The patient likely doesn’t recognize the number, so they may not take the call or return the message. This causes confusion for the patient and results in a delayed start to therapy.
Next, there’s a different department for managing prior authorizations and reimbursement, another for co-pays and patient assistance programs, and yet another for coordinating medication delivery. If the patient has a question after the initial interaction, good luck finding the same person to talk with again or even the correct number to call. For refills, the patient may not have a person to work with at all; instead, it could be an impersonal robocall.
Now imagine you’re a manufacturer that has not one, but several specialty pharmacies serving patients. Now, you have multiple layers of management working inside multiple vendors—with no clear and consistent path for communications among the players. There’s no streamlined path for starting patients on your medication and monitoring their long-term adherence No single source of comprehensive, clean data for analysis and more informed decision making, and no single point of contact for understanding how well your medication is performing in the marketplace. With so many vendors involved you also run the risk of diluting your brand message and loyalty.
Instead of clarity, you’re faced with complexity — but if the traditional service model is the only one you’ve ever known, you may feel there’s no other way so you settle for mediocrity.
An End-to-end, Patient-First Solution is the Better Way
Traditional service models are built for volume, not personal attention. They’re designed to dispense maintenance medications to large patient populations. Automation is essential for maintaining efficiency and cost-effectiveness.
When a rare or orphan patient population is just a few hundred — split among several specialty pharmacies — the volume dispensed by each pharmacy is very low. If a specialty pharmacy is having difficulty getting some patients started on the medication, they may simply drop them from the program. The specialty pharmacy isn’t structured to customize service for individual patients; it’s just not economically feasible for them. Moreover, with such a small volume, the specialty pharmacy won’t likely have dedicated staff to support your program or brand.
In an all-inclusive, patient-first model, no one falls through the cracks. A patient care coordinator is the single point of contact for the entire patient journey and works with each individual to tailor the experience. Some patients have significant concerns, have a lot of questions, and want frequent support. Other patients prefer minimal contact. In either case, a patient never feels “lost in the system.” At Optime Care, our patient care coordinators truly walk with our patients, giving reassurance and supporting quality outcomes according to the wishes of each. Additionally, you will receive a patient care team dedicated to your specific program.
Using a single Specialty Pharmacy inside the patient-first model, you also have the advantage of standardized data —providing a strong foundation for making more informed decisions with confidence. This “single source of truth” can improve adherence by predicting patient behavior. For example, based on historical data you may identify a particular patient cohort that tends to become non-compliant due to side effects. Though single-sourced data analytics, you can identify these patients more easily and contact them at just the right moment to help maintain adherence, benefitting patient and manufacturer alike.
Speaking of manufacturer benefits, patient-first models are more profitable. With fewer vendors to contract with and manage, operational costs are naturally lower. By leaving complexity behind, streamlining your approach and adopting the patient-first model, you’re maximizing your rare or orphan drug’s potential to support the health of patient and manufacturer alike.
