Although the investments of health system-based practice drugstores has grown regularly over the past decade, 2020 will mark a critical year. Payers, providers, and health systems themselves are frequently understanding the vital role multicultural delivery enzymes play in value-based care leadership.
The increase in health system-based practice drugstores has been buoyed by the double-digit annual rates of growth in practice drug prices, linked with an ever-widening number of health systems bearing the responsibility for the high-risk patient communities they serve.
The combined structure of health system-based practice drugstores positions them well for reading on quality case care, as well as assistance with drug companies and payers seeking new possibilities to work with health systems.
Health Systems Lean Toward Specialty Pharmacy and Pharmaceutical Strategy
The concentration of increase in the practice drug market, along with the strengthening of health systems, has created both difficulties and events in the marketplace. On the one hand, a battleground has developed between providers and pharmacy benefit managers (PBMs), who are involved in developing their specialty drugstore revenues.
On the other hand, as a consequence of significant consolidation, multiple health systems now control the significant mass to act as a PBM for their employees and the broader neighborhoods or regions their health plans serve.
The capacity to move the PBM within the health system, or within a group of health systems, implies impending moves from health systems to realign or internalize science benefit administration, which will create natural alignment with stakeholders and facility of use that is lacking in the contemporary PBM landscape.
Additionally, the strengthening of health systems presents them with the means to enlarge their reach into areas of practice pharmacy that encourage drug adherence and continuity of care while managing the total cost of care. Home strain for specialty patients is an example because it is not only available for the patient, it frees up hospital beds for more severe sufferers who require admixture services and can cost significantly less than traditional hospital-based infusion.
Drug Manufacturers Frequently Recognize the Value of Integrated Delivery Networks
As health system-based specialization pharmacies grow and gain accreditations, pharmaceutical companies and medicine manufacturers alike continue to understand the rich data sources these health system-based practice drugstores represent.
Collaborations between health systems across the United States, such as the Excelero Network, represent an even more meaningful data opportunity, as they offer a single source for the highly sophisticated data sets medicine businesses to challenge.
Public health system systems and data aggregator co-workers such as these are useful for two primary purposes. First, they provide single-source access to multiple health systems, which can analyze contracting and data path, reducing bandwidth, and staff required to support an integrated-delivery network policy.
Second, as drug manufacturers seek to gain a more in-depth knowledge of the patient journey within the health system, they now need health system-based practice drugstores to provide the same level of sophisticated data for limited distribution drugs (LDDs) as they need from public specialty drugstore partners.
By working with a network co-worker or data aggregator, data are implemented in a standardized format, which means the data are often even more accessible and absorbable to drug companies. That allows more in-depth penetrations into real-word use of specialization products and a clearer understanding of the care journey.
Partnerships Drive Value-based Results
As price tags for many specialization medications rise for multiple patients in small groups, value-based contracting frequently becomes necessary. Nevertheless, as the data elements are still difficult to define, collaboration among all players—pill manufacturers, data aggregators, payers, and sufferers—will be critical. Drug companies are in the best position to decide which product data are most important, whereas health systems have more insight into which insights will elucidate the patient visit.
Reaching an agreement will help the industry learn the right questions to ask and the best real-world data to mine to gain the understanding needed to decrease the total cost of care and enhance patient outcomes. Additionally, as we gather data from an ever-widening number of health systems, the analysis and integration of these data are an indispensable part of success.
A New Decade
While the currency of the health system-based practice medicine has grown regularly in the previous decade, we have arrived at an inflection point in which the items are now in place to deliver more effective results, especially in meeting broad value-based care purposes. In the coming year, we expect to see health systems better leveraging their combined scale, both with drug businesses and benefits managers, creating a more aggressive margin comparison.
Additionally, health systems will likely continue to extend their patient reach to include areas such as home infusion and preferred specialty pharmacy network participation. This higher degree of collaboration will allow for more comprehensive clinical data sets that would otherwise have been unavailable while providing consumers with timelier therapy management at the point of care.
Overall, if the collaborative spirit we have seen in the industry in recent years continues, we will be on a positive trajectory to better control costs and make health care affordable for our most complex patients.