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Nationwide Children’s Specialty Pharmacy Expands Access to Life-Changing Care

Nationwide Children’s Specialty Pharmacy Expands Access to Life-Changing Care 1024 683 Alaina Doklovic

Nationwide Children’s Specialty Pharmacy is helping more patients access life-changing medications faster.

What began as a focused effort to better serve patients with cystic fibrosis (CF) has grown into a comprehensive Specialty Pharmacy program supporting patients across more than 11 disease states at Nationwide Children’s Hospital. Over the last decade, the program has evolved into an integrated resource that helps families navigate complex medications, insurance requirements and long-term treatment management.

Specialty pharmacies are pharmacies that predominately obtain and dispense medications that are relatively expensive and/or have highly specific monitoring requirements. These medications often require close coordination between providers, insurers and patients, making timely access critical to successful treatment outcomes.

The Specialty Pharmacy program at Nationwide Children’s originally grew out of a need within the Cystic Fibrosis Center. Providers noticed that patients were frequently experiencing delays when prescriptions were sent to outside pharmacies, sometimes returning to appointments weeks later without receiving important medications.

“We noticed that there were many times when we wanted to start new medications (often antibiotics), because they were clinically worse,” said Karen McCoy, MD, former chief of the division of Pulmonary Medicine at Nationwide Children’s. “Many times at a follow-up visit soon after, the medications had not been received and the patients were worse and often would require inpatient admission, which could have been avoided if medications had been received earlier.”

To address these barriers, the CF team partnered with pharmacy leaders to create a more streamlined process that could quickly coordinate prescriptions, insurance approvals and medication delivery.

“The need became even more important with the expansion of cystic fibrosis transmembrane conductance regulator (CFTR) modulators, breakthrough therapies that target the underlying cause of cystic fibrosis rather than only treating symptoms,” says Emily Stephan, PharmD, the Pulmonary Advanced Patient Care Pharmacist in the Specialty Pharmacy. “Medications like Trikafta® have dramatically improved quality of life for many patients, but they are also expensive, highly specialized and often subject to insurance restrictions.”

Today, the Specialty Pharmacy helps patients access these advanced therapies while working closely with pulmonary providers, nurses and care coordinators within the same health system. Because pharmacy staff have direct access to the patient’s medical record, communication is faster and care is more coordinated.

“Having a close relationship between the special pharmacy team, physicians and patients is something that we always like to highlight,” said Dana Wilkerson, PharmD, manager of the Specialty Pharmacy. “We have access to the electronic health information and patient charts, so things can move much quicker and easier. It’s great to keep that care within our own health system.”

Even when an insurer won’t allow the prescription to be filled at Nationwide Children’s Specialty Pharmacy, Dr. Stephan and the other pharmacists and technicians within the team offer themselves as a resource to families. The team continues helping patients navigate insurance challenges, coordinate medication access and troubleshoot issues with outside specialty pharmacies to ensure children receive the therapies they need.

“The Specialty Pharmacy has really helped patients have access to life altering but very expensive and often challenging drugs to obtain,” says Benjamin Kopp, MD, MPH, current chief of the division of Pulmonary Medicine at Nationwide Children’s. “It’s unique to have a specialty pharmacy directly linked and interconnected in our institution, and we don’t have to worry about getting medication shipped from across the United States. It’s right here ready for our patients.”

As new specialty therapies enter the market, pharmacy leaders continue working to reduce barriers to access. Teams evaluate new medications, educate staff, coordinate prior authorizations and prepare systems to support patients as quickly as possible.

“At this point, the families know that they are going to get their medicine,” Dr. McCoy said. “That people are going to pay attention to them.”

That commitment to personalized, coordinated care remains at the center of the Specialty Pharmacy’s mission as the program continues to grow.

 

Image Credits: Adobe Stock

About the author

Alaina Doklovic is a Marketing Specialist for Research Communications at Nationwide Children’s Hospital. She received her BS in medical anthropology and English from The Ohio State University. Her passions for science and health, combined with her desire to help others, motivated her to pursue a career in which she could actively help improve patient outcomes and scientific research through writing.

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