Should Health System Specialty Pharmacies (or IDNs) be Included in Market Access Plans?

Co-authored by Kevin Cast and Kristin Chambers



Designing pharmaceutical channel strategies in today's dynamic marketplace may have you feeling like you have too many options. If your distribution network has already considered independent and payer-owned specialty pharmacies and In-Office Dispensing options, do health system specialty pharmacies (HSSPs) really need to be on your radar?


In a word: absolutely.


Did you know that 9 out of 10 large hospitals operate a specialty pharmacy?* As you think about your network design today, the question has evolved from if you should include HSSPs, to how best to incorporate them.


At first glance, HSSPs appear to be a logical and viable dispensing entity option: they have access to the electronic health record, work in the same health system as the prescribing doctor, and are highly motivated to improve overall patient outcomes for their health system. The two most common options to engage these entities include working directly with the health system pharmacy or utilizing the services and reach of an HSSP network administrator.


Archbow recently surveyed pharmaceutical executives from trade, business development, and market access teams to understand the challenges and opportunities they face working with the growing HSSP market. Key findings included:


  • Eighty percent of respondents included health system specialty pharmacies in their distribution network, and being an academic medical center was the most cited driving factor for inclusion.


  • Very few of our respondents utilized a network administrator to help with HSSP access. This presents an opportunity for Excelera, Acentrus, Asembia, and others to offer the services manufacturers require that individual HSSPs may not have the ability to provide consistently, including payer relations, account management, proactively working with the manufacturer's HUB, and the delivery of quality-assured data.


  • Only thirty-five percent of respondents state receiving combined EHR and dispensing data.


  • The survey highlighted that HSSPs need to demonstrate more agility to work with pharmaceutical companies, especially with the advent of COVID-19.


A surprising insight from the survey is that traditional SPs are perceived to have better adherence numbers, even though this is a common selling point for HSSPs. Where HSSPs are perceived to excel is in patient satisfaction and provider coordination, suggesting that those services may be underappreciated in the market.


The HSSP is here to stay, making it vital for market access teams to understand the ins and outs of working with this essential partner. Pharmaceutical manufacturers can work with HSSPs or their network administrators on formulary placement, coordination with patient assistance and HUB programs, and securing rich real-world evidence including EHR and dispensing data.


Reach out to Archbow to help determine how to maximize your relationship with HSSPs to increase access and improve outcomes for your patients. And stay tuned for our Health System Specialty Pharmacy Trend Report out later this year for a more in-depth look at the players and the opportunities in this space.





*Drug Channels, "Hospitals Continue Their Startling Expansion into Specialty Pharmacy," August 18, 2020. Adam Fein. https://www.drugchannels.net/2020/08/hospitals-continue-their-startling.html

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