Research Projects Page

There is a growing number of specialty medications with requirements that exceed standard characteristics, which VSP defines as "ultra-complex." This article details ultra-complex specialty medications, and strategies implemented by an IHSSP to maintain an optimal patient journey. Ultra-complex specialty medications provide unprecedented therapeutic advancements but demand multidisciplinary resources to reach the desired therapeutic goals, which make IHSSPs an ideal management setting.

This primer describes the structure of copay accumulator, copay maximizer, and alternative funding programs used by payers and self-employers to shift costs for high-priced specialty medications. The primer uses a patient case throughout to highlight the unique structure of these programs and their impact on patient affordability and access.

This study found that health system specialty pharmacist interventions in MS can lead to substantial direct and indirect cost avoidance-up to $156,265 within a 6-month time frame. Most costs were avoided directly by preventing the dispensing of inappropriate therapies and indirectly by preventing additional health care utilization.

Frequently patients are referred to the specialty pharmacy that do not meet the insurance step therapy requirements. We looked at patients with either atopic dermatitis or psoriasis that did not meet insurance step therapy requirements and the outcome after trying the insurance required treatments.

This study compares persistence to HIV PrEP in patients filling their medication through an integrated health-system specialty pharmacy (HSSP) compared to those filling at external pharmacies. These findings demonstrate that patients were better maintained on PrEP therapy when their prescriptions were filled with the HSSP compared to external pharmacies, thus highlighting the role HSSPs can have in ending the HIV epidemic.

This Viewpoint paper describes programs for patients with commercial insurance that employers, health plans, and other payers are using to reduce their own spending on specialty drugs including copay accumulator and maximizer programs and alternative funding programs.

This randomized prospective study evaluated the effectiveness pharmacist interventions had on specialty medication adherence using proportion of days covered (PDC). After 8 months post-enrollment, median PDC in the intervention group was significantly higher than the control group. Currently, 3 products related to this research are below:

This multi-phased survey aggregated data to describe clinical services provided by health-system specialty pharmacies (HSSPs). Results demonstrate that HSSPs are a clinical and educational resource for specialty clinics and have developed robust patient care services that encompass the patient journey from before specialty medication selection through treatment monitoring and optimization.

The goal of this study was to explore healthcare providers’ experiences with specialty medications distributed via Limited Distribution Networks (LDN) that do not include IHSSPs. Participants reported barriers to navigating LDNs that can interfere with clinic workflow and patient care. IHSSPs may reduce clinic burden by helping patients access, afford, and remain on therapy.

This study's findings indicate that access to DAAs in donor-derived HCV post-transplant is achievable and affordable; however, 35% of patients required an insurance appeal requiring significant administrative efforts. Additionally, patients not able to use the on-site specialty pharmacy and those requiring an insurance appeal were 5.8 and 5 times more likely to experience a delay in treatment initiation.