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.

This study evaluated patient-reported outcomes (PROs) and pharmacist interventions in patients serviced by VSP in various clinical conditions. In patients with MS specifically, we found that 98% of patients reported no adverse effects, 90% reported no missed doses, and 98% reported their medication worked "good" or "excellent." Pharmacist interventions were commonly related to adherence, safety monitoring, and adverse effects. PROs can be useful to drive meaningful pharmacist interventions.

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 article highlights the challenges in standardizing adherence methodologies as well as the key elements to consider when interpreting adherence results. Specialty pharmacies should consider using adherence measures to identify and intervene on patients with adherence challenges. In addition, integrated specialty pharmacies should work to link adherence to clinical outcomes and healthcare cost savings.

Because of the growing focus on outcomes research within Vanderbilt Specialty Pharmacy (VSP) and the need for more student research opportunities, VSP developed a longitudinal student research training program. This report describes the development and outcomes of that program as of June 2021.

Most institutions utilize a Pharmacy and Therapeutics (P&T) Committee to create a formulary for inpatient administered medications that promotes cost effective treatment options to reduce hospital related drug costs. Due to their high cost, most specialty therapies are omitted from inpatient formularies. We describe the non-formulary process developed at our institution to expedite and overcome challenges created by inpatient administered specialty medications.