The pharmacy changes lives every day and has provided over $17 million in financial assistance to our patients since opening.
— Kim Metcalfe
Specialty Pharmacy at UConn Health is quietly marking a milestone — two years of simplifying the process of obtaining specialty medications for patients, saving them time, aggravation and money.
It was June 30, 2020, still early in the pandemic, when the specialty pharmacy opened and filled a single prescription on its first day. Two years later, a typical month for UConn Health Pharmacy Services Incorporated is 900 patients served and 1,100 prescriptions filled.
“We’ve had tremendous growth,” says Emmett Sullivan, specialty pharmacy manager. “In the last year, we’ve doubled our staff and our volumes have also doubled.”
By the end of its first year, the specialty pharmacy had achieved the highest level of accreditation in the industry.
“Our success has a lot to do with our personalized, patient-centered specialty service that is integrated into the clinic model,” says Kim Metcalf, associate vice president of pharmacy and ancillary services. “The pharmacy changes lives every day and has provided over $17 million in financial assistance to our patients since opening. Our pharmacy exceeds the national average time to obtain specialty medications by an average of 2.5 days, compared to other national specialty pharmacies that achieve access in 7 to 10 days.”
Specialty drugs often have one or more of the following characteristics:
- They are not widely used, so they are handled through limited distribution channels.
- They are more likely to interact with other medications.
- They may have side effects that the patient should recognize and report to the healthcare team.
- They are usually very high, in some cases up to $500,000 per year. These include oral, injectable and biologic medicines to treat cancer, hepatitis, autoimmune conditions and other rare or chronic conditions.
The integration of specialty pharmacy with patient care at UConn Health offers patients with conditions that require specific — usually expensive — pharmaceuticals more coordinated and often less expensive care.
“Specialty pharmacy takes a complex process and reduces stress for patients so they can focus on their health,” says Sullivan. “If you get a special prescription written by your provider and you walk into your local pharmacy, it probably won’t be available, and if it was, the cost of the drug could be hundreds if not thousands of dollars in co-pays.”
Any co-pay that comes back to more than $10, our team looks for alternative ways to further reduce that cost to the patient.
— Emmett Sullivan
With its dual accreditation with URAC (originally the Utilization Review Accreditation Commission) and ACHC (Accreditation Commission on Healthcare), the specialty pharmacy has greater access to these drugs. Clinical staff work directly with providers to add an additional level of review.
Pharmacy relationships help patients minimize out-of-pocket costs and navigate their additional options beyond insurance coverage. The pharmacy team engaged patients and increased adherence rates to nearly 90%, well above the national standard of 80%.
“Financial barriers are a common reason for lower adherence,” says Sullivan. “Any co-pay that comes back to more than $10, our team looks at alternative ways to further reduce that cost to the patient. The manufacturer may have a co-payment assistance card or may have grants for certain conditions that the connections will research and look out for.
Before the specialty pharmacy opens, a patient needing a specialty drug faces several potential hurdles and delays of two weeks or more. The retail pharmacy may not have the drug. Insurance will often deny these claims, which requires additional information from the healthcare team. It may be redirected back to the insurance plan’s specialty mail order pharmacy and filled in another state, and the patient will have to wait for it to arrive by mail, refrigerated if applicable.
“We’re right here in Farmington and we deliver it right to your door anywhere in the state,” Sullivan says. “It’s temperature sensitive and you’ll be carrying your medication chilled to your house or office. Our average order-to-delivery time is a third of the national average.”
Patients also receive help with prior authorization from their health insurer, reminder calls for refills, keeping their providers updated, and understanding the purpose, dosage, potential side effects of medications, and potential drug interactions.
Although UConn Health’s specialty pharmacy has come a long way in its two years, the plan is to continue on this growth trajectory and expand into clinical areas it is not yet fully engaged with.
“Our personalized care approach has led to better patient care and outcomes,” says Metcalf. “Our pharmacy continues to exceed expectations and our plans for growth in the coming year look very bright.”
Learn more about UConn Health Pharmacy Services Incorporated.