7 ways specialty drug prescribing can be frustrating for providers

November 03, 2016

These days, physicians and nurses have a lot on their plates. Between a growing list of administrative tasks and adjusting to changing payment models, it’s easy to burnout. Plus, for healthcare providers who prescribe specialty medications, paperwork and administrative burden take up a large chunk of their workweek—and time with patients. In fact, we’ve found this is such a huge issue that we’ve made it our mission to develop a technology solution to try and address these challenges.

How big of a burden is it for prescribers?

The time spent managing specialty drug orders is different for every practice and largely depends on how many patients require prescriptions, as well as the type of medications ordered. But, it can be easy to find out—in fact, we’ve put together a calculator to help prescribers estimate how much time they spend each week, just managing specialty drug orders. Warning: it might be surprising! Or, if you’re a prescriber, it might just validate your frustration.

After speaking directly with healthcare providers across the nation, we’ve identified 7 common challenges that weigh down the specialty drug prescribing process for them.

#1 It’s hard to find the right, up-to-date enrollment form.

Many specialty medication enrollment forms are updated at least yearly (and sometimes more often), so it can be tough to find the latest form for each therapy. Some practices have adjusted to these challenges and become “experts” at creating their own internal processes to track down forms—but is this really the best approach? We don’t think so. Worse, if providers fill out the wrong form or an old form, they lose more time by starting over and resending the prescription order in the correct, most up-to-date form. According to a study of providers who treat pulmonary arterial hypertension (PAH), on average it takes nearly 20 minutes just to complete an order.1

#2 It’s too easy to make a mistake.

Most specialty enrollment forms aren’t simple. There’s a lot of information required—and just one mistake can stop the order and restart the clock. In fact, we heard from one physician who used white out to erase a mistake: his order was sent back, and he had to start over, using a brand new form.

#3 Fax machines are outdated and can be frustrating.

Have you ever wrestled with the fax machine (a la “Office Space”)? Chances are, the answer is yes. Since the 1980s, fax machines have had their place in America’s businesses. But, we think they’ve stayed a little too long in the healthcare industry. Here’s the problem: too often, providers fax specialty medication enrollment forms to a hub or specialty pharmacy, but part of the form is cut off. By the time they realize this technology glitch, more time has passed. Then, they have to resend the fax in its entirety.

#4 The patient left the office without signing consent.

Most specialty medication prescriptions require patient consent, and it’s easiest to get this signature when the patient is in the office. However, physicians are more strapped for time than ever before, and too often, obtaining patient consent slips through the cracks. As a result, providers or a hub must mail consent forms and wait days to receive the completed signature.

#5 Frequently, the order goes to the wrong specialty pharmacy.

Many providers send prescription orders to the specialty pharmacy they feel is easiest to use. But, most patients have insurance plans that require a single, designated specialty pharmacy to process the order. In our recent study, we found nearly 58% of patients fit this description.1 As a result, frequently providers send the order to the wrong specialty pharmacy.

#6 Providers find out if prior authorization is needed—too late in the process.

Ideally, a healthcare provider completes a prior authorization (PA) form upfront. But too often, they don’t find out if PA is needed until after the prescription order has been sent. As a result, there is a lot of back-and-forth communication (phone calls and faxes) between providers and payers, making sure the right questions are answered so the prescription can be approved.

#7 There’s a lack of transparency throughout the process.

Currently, there’s no way for healthcare providers, patients, or specialty pharmacies to see when drugs ship to patients, and most importantly, when (and whether) patients are compliant with their therapies. This can make it challenging for physicians to help patients adhere to their treatment plans, as well as see how well patients are doing on their course of treatment.

To read more about providers’ challenges when prescribing specialty drugs, read our ebook “What Ails Specialty Drug Prescribing.”


1 PAH Office Manager Report, Survey conducted by Deerfield Institute and ZappRx (March, 2014).