ASHP Previews Survey Findings on Clinical Services Provided by Health-System Specialty Pharmacies

Specialty pharmacies operated by health systems provide robust, comprehensive patient care services that are guided by targeted monitoring and timely interventions, according to preliminary results from the 2022 National Clinical Services Provided by Health-System Specialty Pharmacies: A Survey of Current Practice.

The survey, conducted by ASHP and Vanderbilt University Medical Center, focused on health-system specialty pharmacy (HSSP) general capabilities and pharmacists’ involvement in pre-treatment interactions with patients, treatment initiation and monitoring, continuity of care services, and education and research activities. The survey is an extension of efforts by the Vanderbilt Health System Specialty Pharmacy Outcomes Research Consortium.

The results demonstrated that health-system specialty pharmacists are well-integrated into patient care processes and clinics.

More than 80% of survey participants who provided data on HSSP clinical services reported a focus on neurology, adult oncology, adult rheumatology, adult gastrointestinal conditions, hepatitis C virus infection, or multiple sclerosis. About a quarter of respondents reported providing clinical care related to fertility services or sickle cell disease.

HSSPs overwhelmingly reported that pharmacists have at least some involvement in medication selection. At least 80% of respondents to this part of the survey reported that a pharmacist sometimes, frequently, or always:

• Reviews prescribed medications
• Discusses clinical alerts with providers
• Collaboratively discusses medication selection with providers
• Selects authorized therapy without having a collaborative practice agreement in place

Autumn Zuckerman, director of health outcomes and research at Vanderbilt Specialty Pharmacy, presented a preview of the survey results June 12 at the ASHP Summer Meetings & Exhibition in Phoenix, Arizona.

“This survey data both demonstrates the great strides health-system specialty pharmacies have made in elevating specialty patient management throughout the patient journey and serves as a measuring stick for HSSPs to continue to improve and lead the field in patient care, education, and research,” Zuckerman said after the session. “Additionally, we hope this data provides needed insight for payers and manufacturers who may be unaware of the advanced, comprehensive care model that HSSPs provide and the close collaboration and connection HSSPs have with the providers and patients we serve.”

In 2020, ASHP launched the first National Survey of Health-System Specialty Pharmacy Practice, which provided insights on staffing, practice models, business operations, prescription volume, quality improvement processes, and clinical operations. The results indicated that HSSP is an integrated advanced practice model for specialty medication-use management across the continuum of care.

The 2022 survey focuses more narrowly on clinical services provided by HSSPs. A total of 127 organizations participated in the online survey.

Key survey findings include:

• HSSP activities and interventions, including insurance navigation, financial assistance procurement, patient response to therapy, initial counseling notes, medication reconciliation results, and patient treatment preferences are routinely documented in the electronic medical record and visible to other providers.
• HSSPs provide extensive medication access, treatment selection, and initial counseling support for all patients referred to the specialty pharmacy. Patients whose prescriptions are filled by the HSSP benefit from additional services.
• Most HSSPs assist with immunization screening.
• HSSPs collect and use patient outcomes data to drive targeted monitoring and interventions. Data on disease-specific outcomes are used for accreditation, reporting, and patient care.
• Integrated HSSP pharmacists and technicians are a clinical and educational resource for specialty clinic staff, student pharmacists and residents, and patients. Initial patient education is largely done telephonically, but some HSSPs provide in-person and tele-visits for patients.

The national surveys on specialty pharmacy practice illustrate ASHP’s commitment to the advancement of specialty practice. The surveys were developed in collaboration with the ASHP Section of Specialty Pharmacy Practitioners and also reflect insights gained from the 2021 ASHP Specialty Pharmacy State of Practice in Hospitals and Health Systems — Future Directions Summit.

Full results of the 2022 survey will be published in an upcoming issue of AJHP.