A guide to improving speed to therapy and adherence in specialty pharmacy

A guide to improving speed to therapy and adherence in specialty pharmacy

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Speed to therapy (or time-to-fill) is one of the most important metrics in specialty pharmacy medication distribution.

There are many stakeholders involved in the complex environment of specialty pharmacy, starting with the patient. But you also work closely with manufacturers, physicians, insurance companies and other payors. Because many of the medications specialty pharmacies dispense are uncommon and expensive, there’s a maze of documentation and prior authorization that needs to be navigated before the patient can begin therapy.

Without question, patients benefit from receiving essential medications as quickly as possible. And there’s broad agreement among specialty pharmacists that it’s vital to increase speed to therapy to improve outcomes. Here are some ideas to accomplish that.


Identifying the cause of delays

There are three main causes that can delay starting therapy quickly: payor-related, financial, and communication.

Payor-related barriers

Handling payor issues can be challenging, especially since the specialty medications patients need are often extremely expensive, which draws a higher level of scrutiny and increased documentation. The specialty pharmacist can help patients manage their coverage by encouraging them to keep detailed records of any communication with their insurer; helping them understand their specialty insurance coverage; and working closely with them on prior authorizations, appeals, and information about any patient access services from drug manufacturers.

Financial barriers

Sometimes patients simply can’t afford the cost of their specialty medications. There are many kinds of patient assistance programs (PAPs) that can make treatment more affordable. Pharmacists can help identify assistance programs and get patients enrolled. If a patient is using a manufacturer’s assistance program, pharmacists can also help check whether payments from the program are being applied to the patient’s out-of-pocket costs.

Communication barriers

Many specialty pharmacies primarily use of paper, phone and fax to communication and coordinate with their stakeholders, which increases potential delays and frustration throughout the patient journey.

Prior authorizations are required for most specialty medications. It can take a week or more to obtain approval when using outdated communication methods such as phone or fax. In addition, manual entry of this information into your pharmacy dispensing system causes duplicate work and leaves room for human error. Using digital documents and electronic signatures, PAs can be sent securely via SMS message or email, resulting in faster signature capture that can be attached to the patient record in your pharmacy dispensing system.


“Overcoming communication barriers is one area where specialty pharmacies can have the most impact improving speed-to-therapy and adherence.” – Melissa Kozak, RN, BSN


medical professional hand typing on computer keyboard


A patient’s adherence to specialty medication can be improved by a higher level of communication and coordination in these areas:

Intake process

Before a patient starts treatment, a pharmacist generally contacts them to gather demographic, medication, insurance and clinical information. This commonly results in multiple phone calls, voicemails and incomplete data. With CitusHealth, a digital form can be sent to the patient to complete at their convenience, leading to more complete, accurate data that can be integrated directly into your pharmacy dispensing system.

Delivery coordination

Scheduling medication delivery can be time-consuming and cause delays in medication refills. Using a real-time communication tool like CitusHealth can streamline the delivery coordination process through secure messaging. Not only is this more convenient for patients, who can respond when they are available, but also for selected pharmacy staff who are notified when the patient responds, bringing efficiency to their communication process.

Care coordination

Monitoring patients throughout their care is vital to ensure treatment efficacy. Monitoring patient adherence and side effects isn’t always timely or convenient when using telephonic communication. Patients may not be comfortable reporting embarrassing side effects over the phone, or they might be in a busy or loud environment. Using multiple methods of communication, such as secure messaging or digital forms, can help you connect with patients and gather critical information regardless of their situation.


The right tools

Technology that enables real-time collaboration between all stakeholders is key to improving speed to therapy. CitusHealth allows users to securely communicate in real-time using a virtual messaging environment. This leads to faster responses, approvals and consents from patients and prescribers. And customizable, digital forms accelerate collecting data and obtaining signatures using our mobile app, SMS messaging or email. Digital forms also make it easier to gather missing or incorrect information by requiring specific fields to be completed and then integrated into the patient record in your pharmacy dispensing system.

It’s important to remember that the physician prescribing the specialty medication is going to look for a pharmacy with a good track record of speed to therapy. CitusHealth allows you to track that metric so you can show how long it took from the moment you received the referral to the time the medication was sent to the patient, helping you build solid relationships with physician partners.


Continuous improvement

Although there have been improvements in speed to therapy, more work is needed to improve system efficiency and patient-centricity. Technology is bringing the system into the digital age. Wider stakeholder involvement will be a key to success, and addressing issues like affordability and communication will keep improving speed to therapy—and patient lives.


Schedule a demo today to learn more about how CitusHealth can help you achieve patient engagement success.

Melissa Kozak
Melissa Kozak
RN, BSN, Co-Founder, President, CitusHealth

As a registered nurse, Melissa has a deep understanding of the post-acute industry. Her extensive clinical care and operational insight led her to become the visionary entrepreneur she is today. With CitusHealth, she’s created our industry’s first end-to-end digital health collaboration platform to solve the complexities of managing post-acute continuum of care and patient and family engagement challenges.