This study evaluates health-system specialty pharmacy (HSSP) pharmacists' roles in medication discontinuations, switches, and dose changes, focusing on cost avoidance. HSSP pharmacists intervene to ensure safe and effective use of specialty medications, preventing unnecessary costs. Pharmacists successfully avoided $129,705 - $162,133 in direct costs through their interventions. These findings support the employment and role of pharmacists in HSSPs, extending beyond prescription filling.

The purpose of the project is to redesign and align the specialty pharmacy Pharmacist Intervention (PI) Assessment with pharmacy organizations, published literature, and pharmacist feedback, allowing detailed documentation that clearly communicates the reason for and outcome of the pharmacist intervention. Key lessons learned are featured to outline steps for replicating the project in other health systems.

There is a growing number of specialty medications with requirements that exceed standard characteristics, newly defined as "ultra-complex." This article details ultra-complex specialty medications, and strategies implemented by VSP 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 health systems 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 quality improvement project implemented the use of tools in the electronic health record that allowed specialty pharmacist to discretely document clinical data for Hepatitis C as part of their normal workflow. Post-implementation, the documentation burden for pharmacists was reduced and documented data was used to create a near real-time dashboard for reporting and tracking patient outcomes.

This Viewpoint paper describes programs 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 study quantified VSP pharmacists’ work performed to facilitate specialty medication education, access, adherence, and persistence for patients who do not use VSP. Across 3 clinics over 5 months, pharmacists performed 1,645 actions for 714 non-VSP patients, equating to 375 hours and $30,429.48 in estimated pharmacist compensation. Lack of visibility in the patient journey and increased workload on providers and health systems is created when payers and manufacturers lockout IHSSPs.

The Vanderbilt Health System Specialty Pharmacy Outcomes Research Consortium partnered with ASHP to disseminate a national survey assessing clinical services provided by health-system specialty pharmacies (HSSPs). Results demonstrated 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.

This qualitative study used focus groups of pharmacy leadership and clinical pharmacists and semi-structured interviews with physician champions to evaluate the development and implementation of CPPAs in an IHSSP. Results demonstrated that implementation of a CPPA in a specialty clinic was thought to improve the quality and efficiency of patient care and was favorably accepted by clinic staff. The IHSSP structure allows CPPAs to be easily integrated in workflow.

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.