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Case Study – Specialty Pharmacy

The Specialty products can present numerous challenges. They require careful evaluation across multiple dimensions like channels of distribution, patient needs, site of care, regulatory requirements, etc. In this business case, the products fulfilled the specialty product profile (e.g. requires high touch pharmacy services, high price, unique dosing, etc.). The products were in four therapeutic areas and it was determined that they would utilize the specialty pharmacy channel. They were distributed in both the retail and specialty pharmacy (SP) channels but were not being optimally serviced.

The combination of the market and channel dynamics, evolving brand needs and pending contract expiration create the call-to-action to re-evaluate the specialty pharmacy channel and contracting strategies.

In addition to this, there were educational needs required to help the organization re-enforce the understanding of what is a specialty pharmacy, what do they do and why they should be paid for what services they provide. This lack of understanding fueled much skepticism and needed to be addressed head-on in the strategy assessment and subsequent new specialty pharmacy strategy.

Plans are nothing; planning is everything.
– Dwight D. Eisenhower

Business Situation

There were various issues internal and external to the SP channel that needed to be addressed. Externally, there were significant changes occurring in the SP channel due to strategic acquisitions and vertical and horizontal business integrations. This had an impact on the channel evolving differing business models and impacting the continuity in the delivery of patient services and data.

The internal processes and external environment required extensive due diligence to ensure the right business decisions were being made about the channel and its value proposition. The financial value proposition needed to be assessed.

The data issues had grown significantly. The data needed to be rationalized, harmonized and formally managed. The brand teams were becoming increasing interested in leveraging the specialty pharmacy value proposition to support much needed patient care requirements, reimbursement issues and increased compliance and persistency. Consistently good quality data and service delivery became an essential enabler for measuring performance and realizing the channel’s potential.

Plan of Action

The due diligence took the form of a comprehensive external and internal assessment. The external perspective benchmarked the SP channel to understand where the channel was and potentially evolving to. This took the form of a segmentation that assessed the SPs value proposition along a continuum. The analysis also looked at various contracting arrangements.

Benchmarking ProcessThe internal assessment reviewed historical business performance for the channel and individual SPs, the financial value proposition, data needs both current and future and a crystallization of the issues and opportunities. The assessment also looked at the internal controls for managing the contracts.

This was an excellent exercise that benefited the redesign of the contracts. It provided great insight into desirable contract controls and for the data management aspects of the contract. It also provided an integration of the payment processes with the contract management, monitoring and account management performance assessment activities.

Business Results

The SP contracting channel strategy was developed in close alignment with the brand teams. The services required by the SPs were aligned with the brand team requirements, and the data was harmonized across therapeutics and customize where needed. In parallel with this were C&P studies to better understand the business impact of the SPs.

The SPs value proposition was confirmed in the studies which demonstrated increased C&P in the specialty vs. retail channels. The quantification of the business value was a critical step to mitigated internal skepticism and helped maintain the focus on leveraging the value of the channel.

The new strategy was developed from the bottom up with brand teams. It was a significant effort to execute over four therapeutic areas, but a blend of contract standardization and customization was done to maximize contract efficiencies. A key step with the brand team and related stakeholders was to prioritize and rationalize the data. This combination step was invaluable to the data management and reporting processes.

Brand Strategy Implementation

The implementation planning was collaboratively done with the key stakeholders (Brand Team, Account Management, Contract Management and the Trade Managed Market Segment) and implemented against an execution plan. The value of the execution plan is extremely important due to the required sequencing of tasks.

All of the collaboration resulted in well executed contracting strategy with a compliant payment process. The subsequent alignments between the managed market segments and account management became increasingly important due to the customer integrations and the desire to closely assess business performance.

The well-defined data management and reporting processes kept senior management, brand teams and account management informed through a specialty pharmacy dashboard and account scorecards. The dashboard and scorecards offered a combination of information consisting of top-line channel and customer metrics designed in alignment with the needs of the various brands and key stakeholders.

Altometrixs Case Studies

With over 20 years of diverse experience in the pharmaceutical and biotech industries, Altometrixs has helped many companies from strategic planning to contracting to critical process improvements. Check out this representational set of case studies to see how Stephen and his team have impacted small and large companies alike, and hear what people are saying:

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