When Valhalla, N.Y.-based Westchester Medical Center Health Network recruited its chief pharmacy officer, Urshila Shah, PharmD, CEO David Lubarsky, MD, gave her an ambitious task: launch an in-house specialty pharmacy within six months.
The health system met that goal.
The decision to launch wasn’t simply about adding another pharmacy service. It was a strategic move to improve access to specialty medications, keep patients connected to their care teams and better manage increasingly complex drug therapies, Dr. Shah told Becker’s.
“Specialty pharmacy has become an essential part of modern care delivery,” she said. As more patients require high-cost, high-touch therapies that involve extensive clinical monitoring, financial assistance and payer navigation, health systems need pharmacy services that are tightly integrated with care delivery.
A six-month launch
The specialty pharmacy opened within six months of Dr. Shah’s arrival — a timeline she acknowledged is unusually aggressive for a project that requires new infrastructure, regulatory approvals and payer contracting.
“We really did have to move at lightning speed,” she said.
The pharmacy initially serves patients in gastroenterology, hematology and oncology, rheumatology, infectious diseases and cardiology, with plans to expand into additional specialty therapies over the next several years.
One factor made the accelerated timeline possible: executive buy-in. “Specialty pharmacy, while it’s led by the pharmacy team, really is a health system initiative,” she said.
Although construction of dedicated pharmacy space was relatively straightforward, regulatory approvals and payer contracting proved to be the most time-consuming components of the project.
The organization had to navigate sequential approvals involving the state board of pharmacy, DEA and NCPDP before completing payer contracts, many of which depend on outside organizations and timelines the health system cannot control.
Unlike many health systems launching specialty pharmacies, Westchester Medical Center completed the build without relying on a turnkey vendor.
Instead, the pharmacy team leveraged prior experience launching specialty pharmacies and existing relationships with payers and regulatory stakeholders.
“The longest and most complex milestones are payer contracting followed by regulatory requirements,” she said. “We did it all internally on our own.”
Measuring success through patient outcomes
While specialty pharmacy can generate financial returns, Dr. Shah said clinical outcomes will be the organization’s primary measure of success.
One key metric is reducing the time between a prescription being written and a patient receiving therapy. According to Dr. Shah, patients using national specialty pharmacies often wait roughly three weeks to begin treatment. Westchester Medical Center’s in-house specialty pharmacy aims to reduce that turnaround to fewer than three days. The health system will also track medication adherence, patient experience and its ability to remove financial barriers that often prevent patients from remaining on therapy.
“I truly believe that the financial value follows that clinical value,” she said. “When patients stay within this integrated model that delivers measurable benefit, the health system can reinvest that financial value into other services.”
Another major objective is improving care continuity. Before launching the specialty pharmacy, all of Westchester Medical Center’s specialty prescriptions were filled by outside pharmacies.
Once patients left the health system for medication fulfillment, providers often lost visibility into whether prescriptions were filled, whether patients remained adherent and whether they experienced side effects.
Today, the organization offers patients the option of using its in-house specialty pharmacy. The pharmacy focuses on providing a better patient experience through faster service, easier access to pharmacists and closer coordination with the care team.
For organizations considering their own specialty pharmacy, Dr. Shah recommends starting early — even before every financial projection is complete.
Because regulatory approvals and infrastructure development can take months, she said health systems should begin building the operational foundation while simultaneously evaluating the business opportunity.
“There is no question for it, you should absolutely launch one,” she said.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
