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Specialty pharmacy turnaround time impediments, facilitators, and good practices

BACKGROUND: Patients receiving specialty medications have conditions that are often complex, high cost, and high need. Prompt treatment initiation is essential for the appropriate management of many conditions treated by specialty products. Improving the turnaround time (TAT) of specialty pharmacy p...

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Autores principales: Gabriel, Meghan Hufstader, Kotschevar, Christopher M, Tarver, DeBran, Mastrangelo, Vittorio, Pezzullo, Lynn, Campbell, Patrick J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372971/
https://www.ncbi.nlm.nih.gov/pubmed/36282928
http://dx.doi.org/10.18553/jmcp.2022.28.11.1244
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author Gabriel, Meghan Hufstader
Kotschevar, Christopher M
Tarver, DeBran
Mastrangelo, Vittorio
Pezzullo, Lynn
Campbell, Patrick J
author_facet Gabriel, Meghan Hufstader
Kotschevar, Christopher M
Tarver, DeBran
Mastrangelo, Vittorio
Pezzullo, Lynn
Campbell, Patrick J
author_sort Gabriel, Meghan Hufstader
collection PubMed
description BACKGROUND: Patients receiving specialty medications have conditions that are often complex, high cost, and high need. Prompt treatment initiation is essential for the appropriate management of many conditions treated by specialty products. Improving the turnaround time (TAT) of specialty pharmacy prescriptions helps ensure patients receive the medication they need in the necessary time frame to optimize health outcomes. Despite a clinical justification for improved TAT, there is a gap in the literature describing what factors impact these times. OBJECTIVE: To determine factors that may influence specialty pharmacy TATs and to identify good practices that specialty pharmacies use to improve TAT. METHODS: This qualitative study used 4 focus groups with specialty pharmacy subject matter experts. Each focus group represented different specialty pharmacy types, including health system, payer-associated, retail chain, and independent specialty pharmacies. Attitudes, beliefs, and experiences regarding specialty pharmacy TAT were captured. Open-ended questions and prompts eliciting impediments, facilitators, and good practices associated with specialty pharmacy TAT were asked of participants. Data were analyzed thematically. RESULTS: Fifteen individuals participated across 4 focus groups: payer-associated (n = 4), independent (n = 3), health system (n = 5), and retail chain (n = 3) specialty pharmacies. Average TATs varied across specialty pharmacy type and by prescription type (clean vs intervention). Several interconnected themes were identified, including barriers with health benefits formulary management, prior authorization delays, differences in requirements between managed care organizations, and miscommunication with physicians, among others. Five subthemes were identified during the discussion of factors influencing TAT, including patient characteristics, pharmacy characteristics, provider characteristics, clinical situations, and health benefit design and formulary considerations. Pharmacy workflow improvements through technology integration are thought to improve TAT. In addition, participants noted facilitators including specialization among pharmacists and technicians in certain diseases, particularly hepatitis C and cancer. Some good practices included using patient financial advocates, technology integration, and a structured patient onboarding process, which were found to minimize delays caused by prior authorization, communication, and formularies. CONCLUSIONS: A multitude of factors impacting specialty pharmacy prescription TAT were identified. Multidisciplinary coordination between pharmacies, physicians, and managed care organizations is essential to ensure patients receive medications in the necessary time frame to optimize health outcomes.
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spelling pubmed-103729712023-07-31 Specialty pharmacy turnaround time impediments, facilitators, and good practices Gabriel, Meghan Hufstader Kotschevar, Christopher M Tarver, DeBran Mastrangelo, Vittorio Pezzullo, Lynn Campbell, Patrick J J Manag Care Spec Pharm Research BACKGROUND: Patients receiving specialty medications have conditions that are often complex, high cost, and high need. Prompt treatment initiation is essential for the appropriate management of many conditions treated by specialty products. Improving the turnaround time (TAT) of specialty pharmacy prescriptions helps ensure patients receive the medication they need in the necessary time frame to optimize health outcomes. Despite a clinical justification for improved TAT, there is a gap in the literature describing what factors impact these times. OBJECTIVE: To determine factors that may influence specialty pharmacy TATs and to identify good practices that specialty pharmacies use to improve TAT. METHODS: This qualitative study used 4 focus groups with specialty pharmacy subject matter experts. Each focus group represented different specialty pharmacy types, including health system, payer-associated, retail chain, and independent specialty pharmacies. Attitudes, beliefs, and experiences regarding specialty pharmacy TAT were captured. Open-ended questions and prompts eliciting impediments, facilitators, and good practices associated with specialty pharmacy TAT were asked of participants. Data were analyzed thematically. RESULTS: Fifteen individuals participated across 4 focus groups: payer-associated (n = 4), independent (n = 3), health system (n = 5), and retail chain (n = 3) specialty pharmacies. Average TATs varied across specialty pharmacy type and by prescription type (clean vs intervention). Several interconnected themes were identified, including barriers with health benefits formulary management, prior authorization delays, differences in requirements between managed care organizations, and miscommunication with physicians, among others. Five subthemes were identified during the discussion of factors influencing TAT, including patient characteristics, pharmacy characteristics, provider characteristics, clinical situations, and health benefit design and formulary considerations. Pharmacy workflow improvements through technology integration are thought to improve TAT. In addition, participants noted facilitators including specialization among pharmacists and technicians in certain diseases, particularly hepatitis C and cancer. Some good practices included using patient financial advocates, technology integration, and a structured patient onboarding process, which were found to minimize delays caused by prior authorization, communication, and formularies. CONCLUSIONS: A multitude of factors impacting specialty pharmacy prescription TAT were identified. Multidisciplinary coordination between pharmacies, physicians, and managed care organizations is essential to ensure patients receive medications in the necessary time frame to optimize health outcomes. Academy of Managed Care Pharmacy 2022-11 /pmc/articles/PMC10372971/ /pubmed/36282928 http://dx.doi.org/10.18553/jmcp.2022.28.11.1244 Text en Copyright © 2022, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Research
Gabriel, Meghan Hufstader
Kotschevar, Christopher M
Tarver, DeBran
Mastrangelo, Vittorio
Pezzullo, Lynn
Campbell, Patrick J
Specialty pharmacy turnaround time impediments, facilitators, and good practices
title Specialty pharmacy turnaround time impediments, facilitators, and good practices
title_full Specialty pharmacy turnaround time impediments, facilitators, and good practices
title_fullStr Specialty pharmacy turnaround time impediments, facilitators, and good practices
title_full_unstemmed Specialty pharmacy turnaround time impediments, facilitators, and good practices
title_short Specialty pharmacy turnaround time impediments, facilitators, and good practices
title_sort specialty pharmacy turnaround time impediments, facilitators, and good practices
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372971/
https://www.ncbi.nlm.nih.gov/pubmed/36282928
http://dx.doi.org/10.18553/jmcp.2022.28.11.1244
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