Biotechnology Healthcare - September/October 2008 - (Page 31)

Figure 2 Nature of SP contact with MS patients Specialty pharmacies were asked: What issues arise most frequently during contacts with MS patients? Medication usage Medication side effects Reimbursement Disease symptoms Shipment Administrative/process Clinical knowledge Formulary problems 10 32 26 53 53 47 84 79 tions, and ensuring step therapy were the three most important objectives cited by MCOs in applying prior authorization for biologic and injectable therapies (Table). SPECIALTY PHARMACY ROLE O’Grady is optimistic that specialty pharmacy can have an impact on benefit design and reimbursement, provide synergy between them, and improve quality of care while minimizing costs. Of the MCOs that participated in the research, 90 percent contract with specialty pharmacies, and 79 percent indicated that their members with MS will be required or encouraged to use a specialty pharmacy to obtain injectable drugs within the next two years. The survey asked specialty pharmacies how frequently they have contact with an MS patient and the nature of that contact. A large majority — 79 percent — said they contact patients once every few weeks or once a month, while 16 percent said they do so once a week. Specialty pharmacy professionals most often discuss medication usage with MS patients; formularies come up as an issue only 10 percent of the time (Figure 2). NEUROLOGISTS’ CONCERNS The complexity of treating MS patients was reflected in neurologists’ responses to various questions in the survey. Perhaps most notably from a standpoint of stakeholder collaboration, neurologists thought specialty pharmacies could provide valuable assistance in helping them stay abreast of biologic products and other MS drugs in the pipeline. Indicative of the desire to share resources and expertise, 68 percent of neurologists surveyed said they would welcome specialty pharmacy’s assistance in managing the treatment of MS patients. Ideally, they said, case managers or pharmacists would administer such a program, which would include contact with MS patients to discuss symptoms, relapses, compliance, and comorbidities, as well as screen for depression and provide administrative relief. Nicholas LaRocca, PhD, associate vice president for healthcare delivery and policy research at NMSS, is somewhat surprised by the posi- tive attitude neurologists expressed toward specialty pharmacy. As the emergence of biologics makes treating the disease more complex, he expects there will be more contact between physicians and specialty pharmacy. P.K. Coyle, MD, professor of neurology at Stony Brook University, on Long Island, N.Y., shares LaRocca’s view, but is taken aback that so many neurologists opt to treat patients with MS rather than refer them to specialists. “With an increasing flow of paperwork and phone calls, the administrative responsibilities have to be overwhelming — especially for neurologists in solo practice.” Kwok, in California, interprets these findings to mean that managing the needs of MS patients requires a multidisciplinary approach in the form of a disease management program. He believes that specialty pharmacy can provide the information and support needed to monitor side effects and suboptimal clinical response, and to help patients gain access to medication. “By sharing the information with the treating physician, the patient will benefit from receiving early and timely intervention assistance,” he says. “Increased communication between all parties is critical in formulating a collaborative solution that will meet everyone’s needs. That is what alignment is all about.” In promoting alignment, Kwok supports a systematic way to demonstrate value in treating the condition. “All caregivers need to communicate, to share pertinent medical and pharmacy data in an integrated fashion,” he says. “If we can implement meaningful interventions and document improvement over baseline measurements, we will be able to quantify [both] the benefits to the SEPTEMBER/OCTOBER 2008 · BIOTECHNOLOGY HEALTHCARE 31

Table of Contents Feed for the Digital Edition of Biotechnology Healthcare - September/October 2008

Biotechnology Healthcare - September/October 2008 Openers Editorial/David B. Nash, MD, MBA Contents At a Glance: Multiple Sclerosis Drug Track Personalized Medicine Healthcare Reform’s Effects on Biologic Access Breast Cancer Status Testing: A Crapshoot With Deadly Odds Trends, Issues, and Perspectives In the Management of MS So High-Tech, Yet So Simple The Evolution of Ascertaining the Value Proposition Specialty Pharmacy Employer to Employer Health Plan Confidential Trends

Biotechnology Healthcare - September/October 2008

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