5 hospital pharmacy trends for 2016 include pharma deals, 340B guidance
Health leaders are looking more and more at pharmacy as a revenue generator, as opposed to a cost burden, McKesson says.
The growth of specialty drugs, and the pressures pharma mergers place on supply chain operations are just a few trends experts at McKesson Pharmacy Optimization expect to shape hospital pharmacy operations in 2016, according to a new report.
"The growing movement toward value-based reimbursement continues to have tremendous impact on health systems as they increasingly look to pharmacy as a source of revenue growth," said Mark Eastham, senior vice president and GM of McKesson Pharmacy Optimization, in a statement. "This need for health system pharmacies to identify new initiatives that can increase revenue without compromising patient outcomes or safety is indicative of key trends and opportunities facing health system pharmacies in the coming year."
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McKesson Pharmacy Optimization, a group of advisors that gauges the value pharmacy brings to the healthcare system, has pinpointed five trends that will impact hospital and health system pharmacies in 2016.
The organization is currently discussing these trends with pharmacy leaders at the American Society of Health-System Pharmacists Midyear Clinical Meeting 2015, running from Dec. 6–10.
Here are the trends:
Continued growth in the specialty market.
Growth in specialty pharmaceuticals spending -- the top spending category for health systems pharmacies -- continues to outpace the growth in the overall pharmaceutical market. The market is seeing an increase in "biosimilars," medical products that are almost identical to currently-available technologies and products; this means specialty pharmaceuticals will start to face increased competition, which in turn will have a positive impact on pharmacies' cost reduction efforts. However, health systems treating patients in the ambulatory setting, and reimbursed through the average sales price model, will see a corresponding drop in revenue. The growth of limited networks and exclusive distribution channels for many specialty pharmaceuticals challenge health systems' continuity-of-care initiatives, but opportunities still exist for those who understand the clinical and operational expertise required for specialty pharmacy.
Health system pharmacy seen as a revenue and margin generator.
Managing costs will always be important, but health leaders are looking more and more at pharmacy as a revenue generator, as opposed to a cost burden. Whether following the old fee-for-service model or transitioning to one that's more value-based, the pharmacy can have a big impact on a health system's bottom line by focusing on incremental revenue opportunities, such as ambulatory, specialty and mail-order services. This can also improve continuity of care and medication adherence, and reduce readmissions.
Industry consolidation increasing need for supply chain efficiency.
So far this year, there's been a lot of consolidation among hospitals and health systems, pharmaceutical manufacturers, retail pharmacy chains and payers. Nearly half of a hospital's total operating expenses are for supplies, drugs and consumables, so large health systems are looking for better integration and efficiency across the supply chain. A properly-scaled, efficient supply chain can streamline workflow, improve productivity and facilitate better inventory management. By analyzing supply spending and patient outcomes, pharmacies can improve network access and improve payer performance.
Increasing oversight of 340B program.
The Health Resources and Services Administration's proposed 340B Omnibus Guidance -- also known as "The Mega-Guidance" -- recently underwent public comment. It clarifies parts of the existing 340B program, such as patient definition, covered outpatient drugs and contract pharmacy. Several new areas are also covered, including specialty pharmacy and limited distribution arrangements. The HRSA hasn't publicized any final guidance on this issue. Health systems and pharmacies, though, would do well to evaluate their current programs to see if the guidance will create any gaps in their programs, and develop action plans to address the potential business impact of these changes.
Leveraging pharmacy analytics to make strategic business decisions.
"Big Data" is still a buzzword in the data industry. A top priority for health systems is using analytics to track and monitor drug spending and use, patient care and quality. This data can be used to make better clinical and financial decisions. Lack of connectivity or interoperability of health records between pharmacy and other providers can be a major safety issue for patients and has continued to be an overall problem in the industry. Initiatives like the Commonwell Health Alliance are making progress, though. The goal is to make healthcare data available and accessible to providers across care settings.
Twitter: @JELagasse
