URAC accreditation

[farmadiazepine]

Hi all!

I don't see independent community pharmacy surviving in the next 10 years if pharmacists continue to only dispense generic medications like metformin, lisinopril, aspirin. These pharmacies aren't even surviving now.

I am looking to get my pharmacy accredited by URAC. Does anyone know or prefer any particular specialty pharmacy consultant to help get accreditation and help implement a lot of the things required of a specialty pharmacy (i.e. a call center, a 24/7 availability of a pharmacy, a PA department, writing of policies and procedures, implementation of programs, etc)?

Any help would be appreciated. I want to fight back and survive in the world of CVS, Walgreens, Rite Aid. This is the way to go.

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[farmadiazepine]

Nobody?

 

[kvl1027]

I'm looking into myself. I operate an independent sterile compounding facility that ships to multiple states. We already have a call center and a clinical pharmacist on staff. I think we're set up well logistically to look at the specialty market. I'll let you know if I find anything else out. I'm definitely going to expire this niche.

 

[farmadiazepine]

Please let me know if you find anything else. You can PM me anytime. Our hesitations to getting accreditation are a couple 1) There is no guarantee that even after accreditation that we will be awarded specialty contracts from PBMs like CVS/Caremark and 2) We do not have a pipeline of specialty customers who we are already serving. We have a huge HIV customer base, but we do not do any other specialty medications. Is it a bad idea to seek URAC accreditation on the hopes of building up the specialty business later?

 

[kvl1027]

Please let me know if you find anything else. You can PM me anytime. Our hesitations to getting accreditation are a couple 1) There is no guarantee that even after accreditation that we will be awarded specialty contracts from PBMs like CVS/Caremark and 2) We do not have a pipeline of specialty customers who we are already serving. We have a huge HIV customer base, but we do not do any other specialty medications. Is it a bad idea to seek URAC accreditation on the hopes of building up the specialty business later?

I wouldn't think so, you have to start somewhere right? I would imagine it to be pretty hard to line the business up without the accreditation. I would think HIV would be a great place to start.

 

[ChalupaBatman86]

I don't want to discourage you but there is way more to opening a specialty pharmacy than just URAC accreditation. That is the tip of the iceberg. A retail type of "specialty" pharmacy where the main specialty therapy is HIV meds could definitely work but would probably not benefit from URAC accreditation. The key thing would to form relationships with patients and prescribers to promote your business.

 

[radio frequency]

Hi all!

I don't see independent community pharmacy surviving in the next 10 years if pharmacists continue to only dispense generic medications like metformin, lisinopril, aspirin. These pharmacies aren't even surviving now.

I am looking to get my pharmacy accredited by URAC. Does anyone know or prefer any particular specialty pharmacy consultant to help get accreditation and help implement a lot of the things required of a specialty pharmacy (i.e. a call center, a 24/7 availability of a pharmacy, a PA department, writing of policies and procedures, implementation of programs, etc)?

Any help would be appreciated. I want to fight back and survive in the world of CVS, Walgreens, Rite Aid. This is the way to go.

Have you contacted URAC directly? From what I've seen, they will help you do what you need to do to meet standards. They don't want you to fail.

Also, as somebody mentioned above, URAC is just the tip of the iceberg. That said, it is a necessary but not sufficient step to success.

 

[BF7]

As of January 2015 the 3 year application fee is $48,000.............and there is no guarantee of business, no guarantee of access to limited distribution medications, nor a guarantee of access to restricted specialty PBM networks. Plus you have to spend for the infrastructure to support the URAC audit. AND you have to pay URAC $2500 per day when they come to do at least ONE on site audit per 3 year cycle of your membership dues.

It's a money grab in my opinion; if they could guarantee access to ALL PBM networks and to ALL specialty medications then it would be worth the investment...it still may work out, but it's certainly a gamble.

 

[farmadiazepine]

We dispense tons and tons of HIV medications. However, we are asked to dispense hepatitis C drugs like Harvoni, Sovaldi, and Olysio, and we run into problems from PBM requiring speciality. We dispense Avonex for years, and now it required to go through specialty. We wanted fill Votrient and Sutent today, and we can get them paid through insurance, however, we can't even get access to these drugs because wholesalers can't give them to us because we are not specialty. Even Pfizer won't allow Cardinal or HD Smith to provide us with Sutent for a patient who has cancer because we are not considered specialty. I can't even get a $14 cost prescription of sildenafil 20mg #30 covered by an insurance because it is required to go to specialty. I can't fill Sovaldi and Olysio to my HIV patient who really needs.

HOW DO I GET MEDICATIONS FOR PEOPLE WHO TRULY NEED THEM? I am more capable of a pharmacist than most of the pharmacists who work in a specialty pharmacy.

WIthout URAC accreditation, limited distribution drugs will not be available to us. PBMs won't allow for specialty drugs to be filled.

Something has to change with the health care system in America, and PBMs and this "specialty" classification are causing a lot of problems. There are extremely capable pharmacists out there who are already providing specialty services but cannot continue to do so anymore.

Does anyone have any advice on how to go about this, or do I spend and extra $100-$200k to get accreditation and implement everything I need to implement?

Thanks for anyone who can help

 

[BF7]

We dispense tons and tons of HIV medications. However, we are asked to dispense hepatitis C drugs like Harvoni, Sovaldi, and Olysio, and we run into problems from PBM requiring speciality. We dispense Avonex for years, and now it required to go through specialty. We wanted fill Votrient and Sutent today, and we can get them paid through insurance, however, we can't even get access to these drugs because wholesalers can't give them to us because we are not specialty. Even Pfizer won't allow Cardinal or HD Smith to provide us with Sutent for a patient who has cancer because we are not considered specialty. I can't even get a $14 cost prescription of sildenafil 20mg #30 covered by an insurance because it is required to go to specialty. I can't fill Sovaldi and Olysio to my HIV patient who really needs.

HOW DO I GET MEDICATIONS FOR PEOPLE WHO TRULY NEED THEM? I am more capable of a pharmacist than most of the pharmacists who work in a specialty pharmacy.

WIthout URAC accreditation, limited distribution drugs will not be available to us. PBMs won't allow for specialty drugs to be filled.

Something has to change with the health care system in America, and PBMs and this "specialty" classification are causing a lot of problems. There are extremely capable pharmacists out there who are already providing specialty services but cannot continue to do so anymore.

Does anyone have any advice on how to go about this, or do I spend and extra $100-$200k to get accreditation and implement everything I need to implement?

Thanks for anyone who can help

simply put, you will be taking a huge financial risk but there are consultants out there that can help guide you through the accreditation process.

http://integralhs.com/accreditation-consulting

 

[kvl1027]

We dispense tons and tons of HIV medications. However, we are asked to dispense hepatitis C drugs like Harvoni, Sovaldi, and Olysio, and we run into problems from PBM requiring speciality. We dispense Avonex for years, and now it required to go through specialty. We wanted fill Votrient and Sutent today, and we can get them paid through insurance, however, we can't even get access to these drugs because wholesalers can't give them to us because we are not specialty. Even Pfizer won't allow Cardinal or HD Smith to provide us with Sutent for a patient who has cancer because we are not considered specialty. I can't even get a $14 cost prescription of sildenafil 20mg #30 covered by an insurance because it is required to go to specialty. I can't fill Sovaldi and Olysio to my HIV patient who really needs.

HOW DO I GET MEDICATIONS FOR PEOPLE WHO TRULY NEED THEM? I am more capable of a pharmacist than most of the pharmacists who work in a specialty pharmacy.

WIthout URAC accreditation, limited distribution drugs will not be available to us. PBMs won't allow for specialty drugs to be filled.

Something has to change with the health care system in America, and PBMs and this "specialty" classification are causing a lot of problems. There are extremely capable pharmacists out there who are already providing specialty services but cannot continue to do so anymore.

Does anyone have any advice on how to go about this, or do I spend and extra $100-$200k to get accreditation and implement everything I need to implement?

Thanks for anyone who can help

There is lot that needs to be done and a lot of capital needed to make it happen. Accreditation is one step, but you really need a network of physicians, solid marketing, people who can negotiate contracts, a clinical team, call-center, multi-state licensure, etc. I know it can be profitable, but hard to get into.

We are licensed in 23 states and working on adding more. We have a call center and clinical staff. We compound medications for the ED market exclusively and have a network of urologists all over the country, so I feel we are set up to make a move into specialty, specifically the novel oral agents for prostate cancer.

 

[BF7]

There is lot that needs to be done and a lot of capital needed to make it happen. Accreditation is one step, but you really need a network of physicians, solid marketing, people who can negotiate contracts, a clinical team, call-center, multi-state licensure, etc. I know it can be profitable, but hard to get into.

We are licensed in 23 states and working on adding more. We have a call center and clinical staff. We compound medications for the ED market exclusively and have a network of urologists all over the country, so I feel we are set up to make a move into specialty, specifically the novel oral agents for prostate cancer.

Www.littlebluepill.com??? I kid....

 

[kvl1027]

Www.littlebluepill.com??? I kid....

Pretty Much!!