COA 2014
Novel Opportunities for Engagement: Utilizing In-House Pharmacy Services
Utilizing an in-house pharmacy may present innovative and efficient opportunities for health providers seeking to improve patient engagement. In general, various trends are reshaping the role of the pharmacist in oncology practice, and the ways in which pharmacies function. Take, for instance, that in recent years, use of cancer drugs has grown between 32% and 42%. Oral chemotherapy regimens in particular have seen a recent rise in FDA approvals. Since 2010, 73% of all oral drugs approved have been oral chemotherapy drugs.

For Angel Aslo, PharmD, pharmacy director at The Mark H. Zangmeister Center, Columbus, Ohio, and Ray Bailey, PharmD, pharmacy director at Florida Cancer Specialists, there have been positive results in transitioning to the use of an in-house pharmacy service for the dispensing of oral oncolytics to their patients. Drs Aslo and Bailey said that it enables them to focus on creating a positive experience for those patients with cancer. However, they note that like their own practices, every organization will require a unique response to how they utilize an in-house pharmacy. Dr Aslo provided the example of how her organization relies on baskets to organize patient information, while Dr Bailey relies on more advanced technology like digital data storage. Despite the differences in operations, they understand that treating patients with cancer requires a rethinking of traditional prescription practices.

“Our goal, both of us, is to make sure that the patient’s experience is what we’re going after,” stressed Dr Aslo.

The speakers went on to describe that there are 2 community oncology practice in-house dispensing models: the physician-dispensing practice and becoming a licensed retail pharmacy. If a health provider thinks they might want to establish an in-house pharmacy of either model variety, they must ensure they strategize its implementation. This includes a health system leadership team designating a person to take responsibility of the in-house pharmacy operations, integrating patient education, considering financial implications, establishing processes for the monitoring and management of the pharmacy, and establishing documentation practices. It also requires strong communication between organizational hierarchies and among different departments.

Dr Bailey warned that these in-house pharmacies are not without their challenges. Some states do not allow physicians to own pharmacies. It also can be expensive for organizations to become accredited for specialty pharmacy dispensing. URAC, which is quickly becoming the accreditation program of choice among professionals, will cost his organization an estimated $70,000 to $80,000.
Despite costs, Dr Aslo maintains that a quality in-house pharmacy can have many benefits for patients. Everything can be done in-house, including checks for preauthorization, dispensing of medications, and reinforcement of patient education.

“We all know we want to take care of the patient,” she said. “Advisable is to see what you currently have that is working for your practice, and use that to make a good oral oncology program.”

Dr Bailey agreed, saying that focusing on patient experience helps the success of a pharmacy.
 
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