OBJECTIVES

Patients receiving specialty medications are often complex, high-cost, and high-need. Prompt treatment initiation is essential for appropriate management of many conditions treated by specialty products. Improving the turnaround time of specialty pharmacy prescriptions helps ensure patients receive the medication they need when they need it. Despite a clinical justification for improved turnaround time, there is a gap in the literature describing what factors impact these times. Therefore, the study objectives were 1) to determine factors that may influence specialty pharmacy turnaround times and 2) to identify best practices that specialty pharmacies utilize to improve turnaround time.

METHODS

This qualitative study used four focus groups with specialty pharmacy subject matter experts. Each focus group represented different specialty pharmacy types, including health-system, payor-associated, chain retail, and independent specialty pharmacies. Attitudes, beliefs, and experiences regarding specialty pharmacy turnaround time were captured. Open-ended questions and prompts elicited impediments, facilitators, and best practices associated with specialty pharmacy turnaround time. Data were analyzed thematically.

RESULTS

Several interconnected themes were identified including barriers with insurance formulary management, prior authorization delays, differences in requirements between managed care organizations, miscommunication with physicians, along with others. Pharmacy workflow improvements are thought to improve turnaround time, with facilitators including specialization among pharmacists and technicians in certain diseases, in particular hepatitis C and oncology, among others. Some best practices included the use of patient financial advocates and a structured patient onboarding process which were found to minimize prior authorization and formulary-related delays.

CONCLUSIONS

A multitude of factors impacting specialty pharmacy prescription turnaround time were identified. Multidisciplinary coordination between pharmacies, physicians, and managed care organizations is important to ensure patients receive medications when they need them.