Specialty Pharmacy

[CardinalGirl210]

Does anyone have any idea about these new specialty pharmacy services that companies are rolling out lately? Is the specialty pharmacy outsourced to a big company? How are the pharmacist "experts" trained - are they going through residency or just being trained by the company? Do the pharmacists primarily deal with counseling or are they also handling the prior authorizations? How do you get a job in this role as a pharmacist?

Here's some links form major pharmacy chains on their services:

http://www.walmart.com/cp/Specialty-Pharmacy/1078924

https://www.cvscaremarkspecialtyrx.com/wps/portal/specialty/

http://www.target.com/pharmacy/specialty

http://www.walgreens.com/pharmacy/specialtypharmacy.jsp

http://www.riteaidspecialtypharmacy.com


ANY THOUGHTS?

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[ravingrabbid]

Can't speak for any of them (except maybe Walgreens). For Walgreens: No, you don't need a residency, it's just your typical store that "specializes" in dispensing certain meds e.g., HIV/transplant/etc. You will be expected to be familiar with whatever disease state and its medications though (duh) e.g., if you're in an HIV specialty pharmacy, you should know the guidelines/treatment/interactions/etc. Your techs will probably be the ones handling the insurance billing/prior authorizations so it doesn't really matter if you do/don't know that. As for training, you'll either attend a class or do some online course and then get the rest of your training at the "specialty" store, ideally speaking. And for getting the job, ask the DM or hope that you float to one of the stores and the staff/manager like you enough to want you to stay.

 

[type b pharmD]

These are great jobs to get. Lots of counseling and the opportunity to stay on top of hot fields and review all the newest, best drugs.

Not sure about the aforementioned spec pharms... my experience has been in dealingwith rphs at accredo, diplomat, and modernhealth specialty pharmacies. They are all basically ecstatic about their jobs. I think they do more counseling and DSM efforts at their jobs than any other dispensing job.

Also, its good to know that in the real world, specialty is basically defined as drugs costing over, say, $30,000/year, and drugs requiring burdensome REMS, close clinical monitoring, and extensive patient education.

Chief examples that come to mind are drugs like sc-IG , tysabri, tarceva, copaxone, aubagio, etc.

You will deal extensively with providers as well as managed care pharmacists.

Pretty sweet job if you can find one. I'd highly recommend it if you enjoy learning more advanced pharmacology and enjoy problem solving.

 

[type b pharmD]

Another cool note. .. you know all those drugs you can never order, like cayston, ampyra, xalkori, tracleer, xyrem, etc... well, that is spec pharm's arena, the so called restricted distribution drugs. Usually for the most restricted drugs, only the PBM's spec pharms get distribution for these. (Ie accredo, caremark)

I really dont know what it means to be a retail specialty pharmacist. Ive never heard of anyone doing specialty outside of the aforementioned mail order houses.

For those that are interested, there is a lot of good info put out by AMCP.

Also, specialty pharmacy volume is growing at about 20% per year, and *IS* the hottest field at the moment imho, as far as, it is on top of everyone's radar in the managed care field, what with literally 50% of newly approved agents being specialty and or biologics.

 

[njac]

I know someone who manages an HIV speciality walgreens.

She did an amcare residency and has taken the HIV boards.

 

[njac]

Another friend did a pgy2 in transplant and was working in the pulmonary hypertension section of Caremark.

 

[mj739]

Are they supposed to be initiating prior auth as well or just following up?

 

[Aznfarmerboi]

Are they supposed to be initiating prior auth as well or just following up?

A good specialty pharmacist should be able to initiate and follow up. For example, at CVS, they are responsible for drug, disease state, national, local, and drug company programs for co pay assist, counseling, and also follow up for refills.

Its a lot of money involved so they keep in contact with the patient through the entire process, the insurance, and also with the pharmacy (for handling of medication) if it is being shipped there.

Sounds like a sweet gig.. low pressured. - For now.

 

[asian pharm]

Does anyone know what "prior authorization pharmacist" is? I see some openings on the job boards that say that they need prior auth pharmacists

 

[mj739]

A good specialty pharmacist should be able to initiate and follow up. For example, at CVS, they are responsible for drug, disease state, national, local, and drug company programs for co pay assist, counseling, and also follow up for refills.

Its a lot of money involved so they keep in contact with the patient through the entire process, the insurance, and also with the pharmacy (for handling of medication) if it is being shipped there.

Sounds like a sweet gig.. low pressured. - For now.

Pharmacists can initiate PAs? I thought only the prescriber or someone from their office could initiate it? Thanks for the info btw!

 

[Aznfarmerboi]

Pharmacists can initiate PAs? I thought only the prescriber or someone from their office could initiate it? Thanks for the info btw!

I am not in specialty so I am unsure. However, I believe they are familiar with the PA process. While they might not initiate the PA, I believe they track it, follow up on it, and even guide the doctors office in the process. This was the information given to us for CVS's new specialty program.

 

[Aznfarmerboi]

Does anyone know what "prior authorization pharmacist" is? I see some openings on the job boards that say that they need prior auth pharmacists

I believe they work for the insurance. Tthey know about the drug therapy and disease state, and can either "approve" or "deny" a prior authorization.

From what somebody told me, they also do more including recommending other therapies that are more cost effective, or works better.