Specialty Pharmacy Discussion

This topic has 2 replies, 3 voices, and was last updated 1 year, 8 months ago by Avatar Donnalussier.

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  • #12526

    Reaching out to see if anyone else is struggling with specialty pharmacy drop ship of medications. At our infusion center, we are experts at the buy and bill process that allow us to control the flow of medication to meet the patient schedule as efficiently as possible. In our experience, when specialty pharmacy is involved, it invariably slows down the process and limits the patients access to rapid deployment of their treatment. This can be frustrating for the patient, the pharmacy, and the payer. It certainly is for us. Is anyone else out there struggling with coordinating and communicating with specialty pharmacies?

    #12549

    Hi Charlie: our infusion center is also heavily into buy and bill and prefer that it remain that way! Our office management has actually decided to turn away specialty pharmacy patients due to low reimbursement, but our physicians are angry that their patients are not infusing here. We currently have 3 specialty patients that have been grandfathered in, and frankly it is an on-going challenge! One of the patients even works for his pharmacy and we have the most trouble getting his medication. If this is the way of the future, like you, we are going to need a better process going forward.

    #14065

    Great Topic!! I work for 2 areas, a Rheumatology Infusion room and an urgent care center. One is uses the Buy and Bill Method, the other Speciality Pharmacy.

    The preferred method, is Buy and Bill. Prior to my arrival as an infusion nurse and manager of the unit I had heard at one time the unit did do some specialty pharmacy buying but stopped due to barriers resulting in administration delays, errors in the medication process, and decreased reimbursement. Now, we do strictly Buy and Bill.

    In the urgent care center, the method used is specialty pharmacy. Currently they are new to infusions and are unable to purchase medications upfront to begin a Buy and Bill process. I am attempting to help them see the benefits of Buy and Bill and am working on some avenues of strategy to present to them.

    So, if anyone is considering a decision as to whether they should use the Buy and Bill method versus the specialty pharmacy method, it is recommended the Buy and Bill method be used. With the Buy and Bill method you can also extend infusion services to Medicare patients since Medicare will only pay if patient using the Buy and Bill method. This will increase your clientele and profit. Medicare does not reimburse as well as commercial insurance but nevertheless it does produces a profit and your infusion clinic exposure.

    Thanks
    Donna

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