Middlesex (Conn.) Hospital has opened its first specialty pharmacy — a move President and CEO Vincent Capece Jr. said will improve care coordination, increase visibility into whether patients receive high-cost medications, and help the system better support those struggling to afford treatment.
The health system decided to invest in the service after recognizing the financial and clinical benefits.
“That product line, service line, something that we’ve seen other hospitals in the industry doing,” Mr. Capece told Becker’s. “It really has a couple of pieces to it. First, it’s certainly business that adds some profitability to our bottom line. So that’s something that we are always looking for to find ways to strengthen the organization financially.”
But the primary focus, he said, was improving medication access and coordination across the system. That means, he said, closer coordination between the doctors who are writing prescriptions and the pharmacy that fills them. This coordination needs to be particularly acute for patients who might have difficulties affording their prescriptions, he added.
The pharmacy sits inside Middlesex’s cancer center, a placement that reflects the types of therapies the service is designed to handle.
“So this isn’t a typical retail pharmacy. It’s primarily for specialty drugs, which tend to be the most expensive drugs out there and the most difficult to get,” Mr. Capece said.
He pointed to patients who rely on medications for conditions such as multiple sclerosis or cancer, as those treatments exemplify the kind of costly, hard-to-obtain drugs the new service is meant to support. To maintain continuity of care for those patients, Middlesex has built a navigator-supported model to keep prescriptions from falling through the cracks.
“Within all of our physician offices, there are pharmacy navigators that will be helping patients with their prescriptions,” he said. “When a physician writes an order, the patient will meet with these navigators to make sure that they understand what the physician has ordered and work with the patient to ensure that they get their drugs in the easiest way possible.”
That may include mail delivery, in-office pickup or visiting the specialty pharmacy — though leaders expect most prescriptions will be mailed or handed directly to patients.
Navigators also began working even before the pharmacy officially opened.
“Our navigators were already kind of mining the patients that we have within our system to identify those that they thought might need some help,” he said. “Prior to actually opening, we already started reaching out to patients to explain the new process that was going to be in place. So I think we’re off to a really good start at the ground running.”
As the specialty pharmacy ramps up, Middlesex will be tracking three measures to understand its impact: how many patients are filling prescriptions through the new service, how often financial assistance is required and whether the pharmacy ultimately contributes margin to the system.
Looking ahead, the focus will remain on strengthening the specialty offering rather than broadening into retail dispensing.
“It’s possible that at some point in the future we could expand the scope of the [specialty] pharmacy that we have … to be more like a full-service retail pharmacy, but I personally don’t see that happening,” Mr. Capece said. “We have a lot of work to do to get our specialty pharmacy up and running and making sure that it’s having the impact that we would like it to have.”
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