2021 was an important year for transforming the specialty medication journey on a national scale. Surescripts expanded clinical intelligence capabilities and disease states and medications while the Surescripts Network Alliance leveraged Surescripts solutions like Real-Time Prescription Benefit and Electronic Prior Authorization more broadly to simplify specialty prescribing, fulfillment, and onboarding.
What does this all mean for prescribers, specialty pharmacists, hubs, and patients? I spoke to my colleague Cecelia Byers, Pharm.D., Surescripts Specialty Clinical Product Advisor, to unpack the innovation we’ve recently delivered in the specialty medications space and its impact on everyone involved.
Before we talk about the progress we’re making, could you tell me what problems we’re trying to solve in the specialty medications space?
Too often, the prescriber and specialty pharmacist experience is very manual. From the way prescriptions are sent to specialty pharmacies and information is gathered, to how doctors, pharmacists and patients contact each other – it's manual all around and lacks automated processes that could facilitate faster and better care.
And patients experience a very time-consuming process, filled with lots of unknowns and time wondering, “What’s next? When is it going to happen? Who am I going to hear from? Who should I contact?”
When I was a specialty pharmacist, patients would call me and say, “I called my doctor, but my doctor told me to call you.” Or, I would call them and say, “We need you to call your doctor and try to get them to take action on this next step.” So, unfortunately, sometimes they are in this middle ground of either having to take action or being stuck with inaction. They can’t do anything except wait.
What have been some Surescripts innovations in the specialty medication space to help solve these problems?
In the past year, Surescripts deepened its clinical intelligence capabilities and expanded disease states and enabled additional medications supported by Specialty Patient Enrollment. This is helping prescribers and specialty pharmacists get more patients started on specialty medications faster and giving them more time to spend on patient care instead of paperwork. The data we’ve seen has been incredible.
How meaningful is it that Specialty Medications Gateway transactions more than doubled in 2021?
2021 was definitely a growing year for Specialty Medications Gateway. For those who don’t know this solution, Specialty Medications Gateway allows specialty pharmacies to retrieve clinical enrollment data directly from the prescriber’s electronic health record when the specialty pharmacy does not receive all clinical enrollment data electronically.
It became generally available at the very end of 2020, and its use has doubled because our customers see the value of the information. Small pilots started with it, but other user groups said, “Hey, I've heard really good things about this clinical information that they're getting. How can I use it as well?”
What other solutions stand out to you?
Although not initially used for specialty prescribing, I think about Real-Time Prescription Benefit and how prescribers can now see cost information upfront for specialty medications, which can be costly. This solution can help the prescribers with the medication selection process, allowing them to factor in what medications health insurance companies will cover and what those costs will be. And having this tool upfront [during the prescriber conversation] helps to prevent sticker shock when the patient reaches the specialty pharmacy.
Can you paint a picture as to how these innovations and technologies work together for a smarter, swifter specialty medication experience?
The reduction in time to therapy is significant, but when you look more closely, the impact is even more expansive than that. For example, if we reduced the number of times that a specialty pharmacy might have to reach out to a prescriber, that not only gives time back to the pharmacy, but also to the prescriber’s office. And the time saved is not usually just a single phone call, it's the time it also takes to gather the information asked for on that call.
I recently sat with a benefits investigation pharmacy access coordinator who was trying to get benefit information for one patient without one of our solutions. It took over fifteen minutes to get benefits information for one patient. But when you think about it even more, collectively it’s at least 30 minutes of time because it’s 15 minutes for two people – the technician and someone at the payer call center.
If the information needed is there at the right time in the moment that matters, that means one less phone ringing and one less fax machine spewing paper everywhere. It frees up prescribers’ and pharmacists’ time to demonstrate their full potential as trusted resources for their patients and healthcare industry partners.
Where would you like the industry and specialty healthcare to be in 5 years? Or what’s the ideal?
In five years, I hope to see the specialty medications space become more understanding of and committed to the vision of electronic integrations, specifically getting more information electronically and moving the needle on more electronic prescribing of these medications. It starts at the prescriber's office and pharmacies and their technology vendors recognizing the need for change and investment with a trusted partner to help them be successful.
As a former practicing pharmacist, I always talk about how health interoperability solutions can help pharmacists practice at the top of their license. But now I realize these tools really allow everyone involved to better succeed in whatever job they’re in because it gives them time back. And that's great because it takes many different hands to support each patient.
Learn more about how Surescripts is simplifying the specialty medications journey.