The IDN pharmacy supply chain plays a vital role in patient outcomes and hospital pharmacy executives continue to look for innovative methods of improving quality while keeping costs low. The problems facing the pharmacy segment of healthcare are complex. Issues concerning compliance, bundled payments, reducing drug spend, and the rising cost of immunotherapies are among the many topics that were discussed.
1:00 pm -- 2:15 pm Specialty Pharma -- Still An Issue
Grand Sonoran JK
Moderator: Joe Quinones, Senior Assistant Vice President for Contract, Administration & Control, NYC Health & Hospitals Corporation
Presenter: Gerald Buller, Director, Specialty Pharmacy Services, Vanderbilt University Medical Center
Specialty pharmacy continues to challenge IDNs in the complexity of distribution, administration and patient management of already hyperinflated drugs. With pharmacy benefit management firms able in some cases to negotiate better prices and frequently offer a complete menu of specialty pharmaceuticals to health plans and employers, the question becomes one of strategy for health systems – do they build their own specialty pharmacy or partner with a commercial vendor?
- Analyze how the decision to build or partner plays out in inpatient care vs. outpatient/ambulatory.
- Outline the financial impact these strategies have.
- Specify what influence major payers have on the decisions health systems make?
2:30 pm – 3:45 pm Bundled Payments and Drugs: A New Role for Pharmacy
Grand Sonoran JK
Moderator: William Martin, Pharm.D., Vice President Sourcing, Purchasing and Value Analysis, Beaumont Health
Presenter: Cindy Williams, B.S. Pharm, FASHP, Vice President/Chief Pharmacy Officer, Riverside Health System
Bundled payment and other programs are going to change how drugs are managed across a health system. Senior health leaders need to form teams with representatives from medicine, surgery, pharmacy, nursing and supply chain centered on services for disease states, and charge them with coming up with plan based on robust data on costs and outcomes.
A few key steps toward developing a long-term plan for the pharmacy piece of bundled payments include:
- A relentless focus on outcomes. Being ruthless when it comes to deciding on using a lower-cost drug or device that may go against established physician practice is essential.
- Focus on physician prescribing patterns and how they correlate with outcomes.
- Taking a second look at generic drugs, even older drugs that may have lost cachet but not effectiveness.
- Making pharmacy an equal partner in post-discharge care.
1. Define episode-based care reimbursement and how pharmacy can play a role in it.
2. Outline strategies for pharmacy to impact care in bundled payment initiatives.
3. Demonstrate why outcomes become such an important metric in bundled payment.
4:00 pm – 5:15 pm Drugs, Biologicals, and Immunotherapies: Life Savers, but at A Cost
Grand Sonoran JK
Moderator: Winna Asuming, PharmD, Pharmacy Operations Manager, St. Joseph Health
Presenter: Bonnie Kirschenbaum, Consultant, Columnist
Operating income plummets, revenue sinks, dire straits ahead! Have you seen these headlines? Were they referring to your facility? How is your facility responding to the financial pressures that are beleaguering healthcare both today and in the future? There’s no question that managing costs is at the top of all healthcare executive agendas and management of pharmaceutical costs is at the forefront. Some facilities are putting limits on or cutting back on the use of high-cost drugs. Some are rejecting others for formularies, which puts pharmacy into the difficult and tense debate with clinicians who want to offer cutting-edge medications to their patients. Proactively, others are developing or honing a biosimilar strategy. But wait, there’s another side to the pharmacy budget. It’s the revenue side! Several facilities also are exploring ways to capture more revenue to succeed in the current challenging economic environment including partnering with payors. This session is a discussion of these issues.
- Determine the impact of payors and the idiosyncrasies of working with them.
- Examine possible solutions on costs.
- Develop new strategies that shake out old habits and question policy.