Breaking down medication access barriers through innovative pharmacy solutions
At a glance:
Accelerate Pharmacy Solutions experts, Joe Vadakara, PharmD, MBA, MPH, FACHE, and Rachel Kelly, PharmD, BCPS, CSP address the operational strain health systems face as specialty drugs become 75% of new medication launches. The discussion covers how workflow inefficiencies—from fragmented benefit verification to complex prior authorizations—prevent clinicians from practicing at the top of their license and explores how standardized processes and support services help reduce administrative burdens.
The healthcare landscape continues to evolve, bringing with it complex challenges that demand innovative solutions. Specialty, infusion, and ambulatory pharmacy settings are uniquely positioned to address critical issues such as medication access and affordability, yet rising bottlenecks require new strategies to transform patient outcomes. During a recent webinar hosted by the National Association of Specialty Pharmacy (NASP), industry experts Joe Vadakara, PharmD, MBA, MPH, FACHE, Senior Director of Pharmacy Operations and Rachel Kelly, PharmD, BCPS, CSP, Managing Director of Pharmacy Practice Solutions of Cencora’s Accelerate Pharmacy Solutions team highlighted pressing challenges in medication access and affordability while exploring actionable insights into how service models and collaborative approaches and redefine patient care in specialty pharmacy.
Medication access barriers facing health systems
Medication access remains one of the most significant challenges for health systems. Specialty drugs are now projected to account for 75% of newly launched medications within the next five years1, and this shift has increased both costs and coverage hurdles for patients. Additionally, new categories of injectable medications like GLP-1s, often referred to as “specialty lite” drugs, bring affordability barriers that complicate access.
With rising out-of-pocket costs, patients are more frequently taking advantage of valuable resources such as foundations, manufacturer programs, and secondary insurance to confidently manage and afford their medications. Health systems are under increasing pressure to navigate prior authorizations, benefit verifications, and contracting requirements to support medication access, especially as payer and manufacturer restrictions grow more complex.
Workflow inefficiencies and technology barriers
The challenges in specialty pharmacy and medication access contribute to significant strain on health systems, extending beyond operational inefficiencies. Administrative burdens often prevent clinicians from focusing on patient care and practicing at the top of their license. Meanwhile, patients face delays in receiving their medications due to site-of-care restrictions, payer policies, and complex medication access workflows. These delays can lead to reduced treatment adherence, poorer health outcomes, and increased frustration among patients.
Research indicates that as many as 65% of patients experience delays in accessing their medications.2 This highlights the need for health systems to address inefficiencies in workflows, standardize processes, and break down silos across departments. Streamlining operations can improve patient satisfaction, reduce treatment delays, and help health systems operate more effectively in a competitive healthcare landscape.
Innovative medication access solutions
Despite the challenges, specialty, infusion, and ambulatory pharmacies are uniquely positioned to drive transformative change through innovative service models that improve medication access, affordability, and patient experiences. Health systems can use different strategies to address these inefficiencies including:
- Optimizing workflows to eliminate bottlenecks in benefit verification and prior authorizations.
- Leveraging cross-department collaboration to standardize processes and reduce inefficiencies.
- Exploring opportunities to expand 340B programs, biosimilar utilization, and other cost-saving initiatives.
- Investing in partnerships and solutions to streamline administrative tasks, minimize delays, and reduce documentation burdens.
These foundational changes can help health systems improve operational efficiency, reduce administrative strain, and enhance patient care. Learn more about how the Accelerate Pharmacy Solutions team offers a variety of solutions to address these areas in the clip below:
Holistic, tailored solutions
Accelerate Pharmacy Solutions delivers flexible, scalable services designed to address the unique challenges faced by health systems. Whether a health system is building specialty pharmacy services from the ground up or refining existing operations, our team works to develop solutions that align with specific needs and goals. Below is a closer look at some of the services we offer to support health systems in optimizing workflows, improving medication access, and enhancing patient care:
- Consulting services: Accelerate Pharmacy Solutions helps health systems optimize specialty, infusion, and ambulatory pharmacy operations by addressing inefficiencies, navigating access barriers, and identifying growth opportunities. Through discovery sessions, the consulting team assesses challenges like bottlenecks in workflows, restricted access programs, and underutilization of 340B programs and biosimilars. Consulting services can help streamline benefit verification and prior authorization processes by identifying opportunities for automation or improved technology integration. Additionally, the team evaluates and recommends solutions for reducing administrative burdens caused by manual processes, empowering health systems to improve patient care and reduce delays.
- Managed services: Our Pharmacy Navigator program helps address staffing shortages and administrative burdens by providing trained pharmacists and technicians who specialize in medication access workflows. These professionals manage tasks such as benefit verification, prior authorizations, and affordability investigations, freeing up clinic staff to focus on patient care. By standardizing processes and reducing variability, the Navigator program can help health systems overcome inefficiencies in workflows, allowing team members to work more effectively. Our team of pharmacists also provides expertise in medication recommendations, collaborates with providers, and supports workflows for better patient outcomes.
- Centralized support teams: Scalable centralized support teams help health systems streamline administrative processes, including benefit verification, prior authorizations, and financial assistance. These remote teams address inefficiencies caused by fragmented systems by consolidating administrative tasks into a single workflow, reducing delays and duplicative efforts. This team can also assist patients directly by connecting them with manufacturer programs, foundations, and other resources to address affordability challenges. By outsourcing these tasks, health systems can reallocate resources to focus on strategic initiatives while improving efficiency and patient satisfaction.
- Patient medication access services: Patient medication access services focus on reducing financial barriers by working with manufacturers, payers, and foundations to identify the best affordability options. These services help health systems navigate co-pay programs, foundation grants, and patient assistance programs, addressing the affordability challenges that often delay access to therapy. By integrating these services into pharmacy workflows, health systems can simplify complex administrative tasks, reduce the burden on clinic staff, and provide patients with timely access to their medications while minimizing out-of-pocket costs.
Driving patient-centered outcomes
Specialty, infusion, and ambulatory pharmacies directly impact medication access and patient outcomes. Health systems that modernize service models and workflows see reduced bottlenecks, improved efficiency, and better patient experiences.
Accelerate Pharmacy Solutions partners with health systems to transform pharmacy operations. We provide the expertise and solutions needed to address your specific challenges—from consulting and centralized support to managed services and beyond.
The opinions expressed in this article are solely those of the author and do not constitute legal advice. Cencora, Inc., strongly encourages readers to review available information related to the topics discussed and to rely on their own experience and expertise in making decisions related thereto.
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