Specialty drugs are in a unique class for a variety of reasons including their high cost, complex formulations, targeted purpose, limited supply, complicated administration requirements, prior authorization requirements, and manufacturer-required recordkeeping. Not surprisingly, stakeholders – including specialty pharmacists – have an interest in monitoring these medications as a way to track their effectiveness and cost efficacy, monitor adverse side effects and interactions, gain insight into preferred dosage strength, and other usage variables. Specialty pharmacists capture this information via clinical assessments which Pharmacy Times has described as a long-standing “cornerstone of patient-centric specialty pharmacy care.”
Clinical assessments, also referred to as “patient questionnaires,” allow pharmacists to capture critical metrics about a specialty drug’s performance, information that is then used for multiple purposes that include:
- Patient Well-Being: Assessments help monitor individual reactions to a specific drug, including changes in symptoms and potential health improvements. Assessments also capture information about allergies and side effects, dosages, symptoms, ease-of-use, and overall impact on a patient’s well-being.
- Cross-Team Care Coordination: Patient information is shared with members of a patient’s healthcare team to ensure complete information is available in the decision-making process, and to facilitate communication between caregivers.
- Drug/Disease Management: Assessments capture valuable information that assess a drug’s effectiveness in treating illness and chronic conditions. Data gleaned from assessments help determine dosage recommendations, identify side effects, and allow researchers access to detailed information about a medication’s performance.
- Accreditation: As required by national organizations that oversee specialty pharmacy accreditation. Examples include the Accrediting Commission for Health Care (ACHC), the Utilization Review Accreditation Commission (URAC), and The Joint Commission (TJC).
- PBM/Network/Manufacturers: As required by third-parties including payers and manufacturers as a condition for inclusion in their networks. Assessments may also be required by manufacturers to gain approval to dispense a certain medication.
Clinical assessments have never been more important in helping to manage specialty medications. But, as Pharmacy Times points out, as the role of assessments has evolved, so too must the information they capture. This highlights the need for flexibility in developing assessments, and the ability for pharmacists to capture this information efficiently, without adding administrative steps to an already laborious dispensing process.
PrimeRx addresses this need with a comprehensive clinical assessment tool. This tool, developed with the needs of specialty pharmacies in mind, allows pharmacists to easily create and maintain customized clinical assessments, usually with just a few clicks of the mouse. Key attributes of the PrimeRx clinical assessment tool include:
- Direct access from PrimeRx homepage. Pharmacists can access the Clinical Assessment feature via a button located right on the home page. No need to jump between screens hunting for the required entry point.
- Linkage by drug category. Medications that fall under a specialty drug category (i.e., Antineoplastic drugs, Disease-Modifying Anti-Rheumatic Drugs (DMARDs), Immunomodulatory Agents), will automatically trigger a “Clinical Assessment Required” alert box. The pharmacist can then click on the alert box for direct access to the appropriate assessment.
- Clinical Assessment Development. Pharmacists can choose from a range of pre-loaded topics to include in an assessment, or they can add their own specific topics. Possible questions to list include:
- Date of last treatment.
- Dosage of last treatment.
- Did your health improve/decline after your last injection of this medication?
- Did you experience any side effects or health concerns following your last treatment?
PrimeRx allows pharmacists to add questions directly as each clinical assessment is formulated. There are no limitations on the number of questions that can be added, or on the topics included.
- User-Friendly. Pharmacists can quickly and easily build and access clinical assessments. In addition, to direct homepage access, the tool can be found via a patient record, or via direct links with each specialty drug.
- Report Generation. Pharmacists can generate reports based on information included in clinical assessments. Reports can be requested across a wide range of topics, based on a pharmacist’s needs and interests. For example, a pharmacist interested in tracking Humira® side effects can easily request a report that details all reported side effects. Reports can be very specific in nature, or wide-ranging. Reports can also be requested on a recurring basis.
- Cross-Team Transmission. Clinical assessments can be transmitted to appropriate stakeholders including payers, regulatory officials, manufacturers, and patient caregivers.
As specialty drugs continue to account for a disproportionate share of the nation’s drug costs, stakeholders – including pharmacists – will increasingly be called upon to monitor the validity of these critical medications. According to Evernorth Health Services, “even though less than 2% of the population uses specialty drugs, those prescriptions account for a staggering 51% of total pharmacy spending.” Further, Evernorth notes, plan sponsors “see an average annual cost of $38,000 to cover a specialty patient’s drugs compared to just $492 for the coverage of a non-specialty patient’s costs.”
Excessive cost, unfortunately, is an unavoidable factor in providing these life-saving medications to patients. And as researchers continue to bring increasingly innovative and targeted medications to market, the need to effectively “prove their worth” will only increase. PrimeRx will be ready, with flexible pharmacy management software that facilitate access to drug metrics, and track patient outcomes.
