Although the currency of health system-based practice drugstores has grown regularly over the past decade, 2020 will mark a significant year. Payers, providers, and health arrangements themselves are increasingly understanding the vital role combined delivery resolutions play in value-based care leadership.
The growth in health system-based practice drugstores has been buoyed by the double-digit annual rates of increase in specialization drug costs, coupled with an expanding number of health systems bearing the responsibility for the high-risk sufferers’ communities they serve.
The combined structure of health system-based practice drugstores places them well for viewing on quality sufferer’s care, as well as assistance with medication companies and payers seeking new possibilities to work with health systems.
Health Systems Lean Toward Specialty Pharmacy and Pharmaceutical Strategy
The concentration of growth in the practice drug market, along with the consolidation of health systems, has created both difficulties and events in the marketplace. On the one hand, a battleground has developed between providers and prescription benefit managers (PBMs), who are involved in growing their specialty pharmacy revenues.
On the other hand, as a result of significant consolidation, many health systems now control the critical mass to act as a PBM for their employees and the broader communities or regions their health plans serve.
The ability to move the PBM within the health system, or within a group of health systems, implies threatening moves from health policies to realign or internalize chemistry benefit administration, which will produce a natural association with stakeholders and ease of use that is lacking in the current PBM landscape.
Additionally, the strengthening of health systems presents them with the means to increase their reach into areas of practice medicine that support drug adherence and continuity of care while managing the total cost of care. Home infusion for practice patients is an example because it is not only available for the patient, it frees up hospital beds for more severe patients who require strain services and can cost significantly less than traditional hospital-based infusion.
Pill Manufacturers Increasingly Identify the Value of Integrated Delivery Networks
As health system-based practice drugstores grow and gain accreditations, pharmaceutical organizations and medicine manufacturers alike continue to receive the rich data sources these health system-based specialty drugstores represent. Collaborations between health systems across the United States, such as the Excelero Network, draw an even more critical data event, as they offer a single source for the highly sophisticated data sets medicine companies to require.
National health system networks and data aggregator partners such as these are useful for two primary purposes. Initial, they provide single-source access to multiple health systems, which can simplify decreasing and data access, reducing bandwidth, and personnel required to maintain an integrated-delivery network policy.
Second, as medication companies seek to gain a deeper understanding of the patient journey within the health system, they now require health system-based specialty pharmacies to provide the same level of sophisticated data for limited distribution drugs (LDDs) as they need from national specialty pharmacy partners.
By working with a system co-worker or data aggregator, data are provided in a standardized format, which means the data are often even more convenient and digestible to drug companies. That allows more in-depth insights into real-word use of specialization products and more precise knowledge of the subject journey.
Organizations Drive Value-based Outcomes
As price tags for many specialization medicines rise for complicated patients in small populations, value-based contracting becomes increasingly necessary. Nevertheless, as the data specifications are still difficult to define, collaboration among all players—drug manufacturers, data aggregators, payers, and patients—will be critical. Drug companies are in the best position to determine which product data are most relevant, whereas health systems have more knowledge into which insights will elucidate the patient visit. Reaching a consensus will help the industry determine the right questions to ask and the best real-world data to mine to gain the insights needed to reduce the total cost of care and improve patient outcomes. Additionally, as we gather data from an increasing number of health systems, the analysis and synthesis of these data are an essential factor to success.