February 16, 2019

Developing a Distribution Plan for Your Specialty Product

By Dan Steiber, RPh, Specialty Pharmacy Times
Published Online: Monday, Jan 07, 2019

In the last several years, accreditation has become the industry standard. For listings of accredited specialty pharmacies, consult the websites of the 2 major accrediting bodies, URAC and the Accreditation Commission for Health Care. The position of URAC is that their programs lead specialty pharmacy third-party accreditation in the industry, among payers. Make no mistake though, accreditation makes a difference. The increased desire for discrete quality-management strategies is a good indication of the shift toward superior coordinated care. This industrywide movement is cemented by the preference of payers that specialty pharmacies achieve third-party accreditation to confirm their commitment to quality, cost containment, and proper utilization of services.

When it comes to accreditation and the quality measures it illustrates for industry stakeholders, it is worth examining the standards of an accreditation body to see how the diverse pieces of the puzzle fit together. To illustrate the full-service elements that accreditation necessitates for specialty pharmacies, we need to explore some of the patient-centered standards from URAC.

As background, URAC specialty pharmacy accreditation standards cover a broad range of services that include drug handling, operations, and patient management. According to URAC, its primary elements of specialty drug accreditation, each of which contains its own standards for quality, are:

1. Customer service, communications, and disclosure

2. Specialty drug management

3. Pharmacy operations

4. Patient management

Managed care health plans are mandating URAC specialty pharmacy accreditation for several reasons. One is that the Affordable Care Act mandates health plans to have URAC health plan accreditation. It also helps align their standards for accreditation with the organizations they partner with and align both quality goals and clinical oversight. Another reason health plans mandate URAC accreditation is because it helps to narrow their network of pharmacies.

Accreditation also helps ensure that the specialty pharmacies that health plans partner with have solid third-party validation of their operations and foster continual improvement by regularly updating current best practices that help enhance operations and services.

In addition, several managed care health plans recently mandated in RFPs that specialty pharmacies have URAC specialty accreditation, which holds an organization accountable on several levels. For one, it forces an organization to review and implement new policies and procedures as the industry evolves. This guidance can help assure that your selection of partners aligns with the leaders in the specific specialty services and products that are provided for your product.

VENDOR SELECTION TRENDS ​​​​​​​

About the Specialty Pharmacy Times Industry Guide

The Specialty Pharmacy Times Industry Guide includes comprehensive editorial content relative to all specialty pharmacy stakeholders. Content includes information relative to market trends, commercialization, distribution, order to cash, HUB Services, managed care strategies and DIR fees. The guide also includes profiles, and a complete list of stakeholders along the patient journey: specialty pharmacies, wholesaler distributors, manufacturers, support services, group purchasing, and trade associations.

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