It’s no secret managing specialty drugs is inefficient and time consuming for providers. What you may find surprising, however, is how this inefficiency impacts clinical care. Nearly 76% of physicians say they’ve switched patients’ treatments to avoid glitches during prior authorization, which is one of the many steps in a long and winding process.1 Today, nearly 30% of U.S. drug costs can be attributed to specialty medications, and the specialty pipeline continues to grow; so it’s unlikely physicians will be able to avoid dealing with this prescribing hassle in the future. 2
Time is of the essence
As specialty drugs become more commonplace, it is critical for providers to identify an efficient workflow. Even though health care is moving toward fee-for-outcome-based payment models, most physicians are still compensated by how they spend their time and the number of patients they treat. Here are a few suggestions for improving how your practice manages specialty drug orders.
Hire and train the right team.
Consider hiring and/or assigning an administrator or office manager to focus on organizing the myriad of forms and patient follow-up. Look for someone with a clinical background who is talented at communication, organization, and administration. If hiring isn’t in your practice’s budget, look for someone within your team who can expand his or her skillset to support the process.
Make a checklist for each drug.
We like to say, “specialty drugs are truly special.” Every brand and health plan has different requirements, and it can be extremely difficult for providers to keep track of the medical and background information needed to secure authorization for a drug. Unfortunately, 28% of pulmonary arterial hypertension (PAH) providers we surveyed say 15% of the time, they must make corrections to an order.3 This re-work only adds time to a process that can already stretch across days or even weeks, making it all the more important not to miss anything on the “front-end” of the process.
To combat confusion and avoid missing paperwork, spend extra time up front creating a checklist for your practice’s most frequently prescribed drugs. One of the most well received features of ZappRx’s technology platform is a process checklist —so you never have to worry if you’ve missed a critical piece of information that will result in a delay in therapy.
Stay on top of the order’s progress.
This is easier said than done. It can be hard to reach specialty pharmacies or connect with patients on the status of their order. An overwhelming 58% of the PAH providers say they never receive a confirmation on when or whether a medication has been delivered to a patient.3 We recommend establishing strong relationships with specialty pharmacies, and of course, your patients. Consider a program that rewards patients for updating you about their medication’s arrival. Finally, explore innovative technologies in the marketplace to improve communication with patients and specialty pharmacies.
Collect data and study the process.
The more you know, the more you can improve your process internally. Ask pharmacies, payers, and your patients what your practice can do to make the process easier. Schedule a regular staff meeting to discuss your practice’s unique challenges, as well as the progress you’ve made. Rely on peers in your specialty who can share their challenges and offer helpful tips. Medical conferences are the perfect place to band together to explore new solutions and learn from one another. Finally, collect data and study as many steps in the process as possible to identify bottlenecks and areas for improvement.
Explore new technologies.
Over the past few years, health care startups have boomed as creative entrepreneurs continue to work hard to disrupt health care. There’s a widely recognized market for new solutions too—in fact, the number of venture funding deals in digital health startups increased by 200% between 2010 and 2014.4
Embrace new technologies and solutions to bring greater efficiency to your practice and give you more time to spend with patients. ZappRx’s specialty prescribing platform is just one of the new technologies in the market that allows you to focus on patients, not paperwork. Learn more about our solution here.
1 Frost & Sullivan. The Impact of the Prior Authorization Process on Branded Medications: Physician Preference, Pharmacist Efficiency and Brand Market Share.
2 Specialty drugs will account for 50% of all drug costs by 2018, Formulary, June 1, 2013
3 Survey conducted by Deerfield, “Internal ZappRx Report,” (2015).
4 Lorenzetti. Health care startups are booming. Here’s what it takes to succeed. Fortune Magazine (February 2015).