Evaluating and Optimizing Health System Specialty Pharmacy Operating Models with Fairview Pharmacy Solutions | NASP Specialty Pharmacy Podcast

Sheila Arquette (0:05)

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SPEAKER_2 (0:10)

Welcome to The Pharmacy Podcast Network.

SPEAKER_3 (0:26)

You are listening to the NASP Specialty Pharmacy Podcast, a collaboration between the National Association of Specialty Pharmacy and The Pharmacy Podcast Network. Each episode dives deep into trends, challenges, innovations, and patient-centric practices shaping the future of this dynamic and rapidly evolving industry. Whether you're a pharmacist or healthcare provider, patient advocate or industry leader, you'll hear expert insights, real-world evidence, and thought-provoking discussion that highlights all that makes specialty pharmacy special.

SPEAKER_2 (1:00)

In support of NASP's mission to empower specialty pharmacy stakeholders to advance the standard of patient care, NASP supports a free market health care system in which all specialty pharmacies compete on the same fair and level playing field because that is in the best interest of the patients we collectively serve. NASP is committed to working with all stakeholders and policy makers to ensure that all patients have access to the life-saving medications they need and the high-touch patient care and support services they deserve from the pharmacy of their choosing.

Sheila Arquette (1:31)

Hello, my name is Sheila Arquette, and I am the president and CEO of the National Association of Specialty Pharmacy. I am delighted to welcome my special guest, Mel Nelson, PharmD CSP to this episode of the NASP Podcast. Mel Nelson leads Fairview Pharmacy Solutions Specialty Pharmacy Consulting Practice, partnering with health systems nationwide to develop, launch, and optimize specialty pharmacy programs that improve patient access, operational performance, and financial sustainability.

She brings more than 20 years of pharmacy experience, including the past 12 years dedicated to specialty pharmacy leadership and strategy. Mel has been with Fairview Pharmacy Services for more than 18 years, and most recently served as Director of Specialty Pharmacy before assuming her current consulting leadership role. She advises health systems on specialty pharmacy program development, payer and limited distribution drug strategy, accreditation, medication access services, technology optimization, and specialty pharmacy revenue capture. Through this work, she helps organizations build scalable programs that support long-term growth.

Mel earned her doctor of pharmacy degree from the University of Minnesota College of Pharmacy in 2011 She's a certified specialty pharmacist, serves on the National Association of Specialty Pharmacy Education Committee, and is an active member of the health system-owned specialty pharmacy community. Mel, thanks so much for joining me today.

Mel Nelson (3:00)

And thanks for having me, Sheila.

Sheila Arquette (3:02)

So over the last decade, we've seen tremendous growth in health system specialty pharmacy, and accelerator organizations have certainly played an important role in that journey. From your perspective, how has the specialty pharmacy landscape evolved?

Mel Nelson (3:16)

Yeah, you know, it's really pretty remarkable how much. It has changed over the past 10, 15 years, and I came into the space about 14 years ago, 12, 13 years ago, and, you know, back then, it was really kind of relatively early in its development, and we've really seen extraordinary growth since. I was looking at some ASHP studies, and they reported in 2015, only about 8% of health systems reported having specialty pharmacy. By 2019, that had grown to just over 25%, so more than a threefold increase in just those four years, and I think that accelerators really played a huge role in that growth. They helped many of those health systems establish their programs, and some of those programs may have never gotten off the ground otherwise. So, I mean, as you know, it's not simple to get specialty pharmacies started. There's a lot of expertise required around accreditation and clinical workflows, you know, technology, market access, you know, all the staffing and analytics, and, you know, accelerators really helped package those capabilities and allowed organizations to, you know, move much faster than they could have independently. So, since that time, I think, you know, the specialty pharmacy landscape has evolved significantly. Today, we're looking at much more, you know, mature health system, especially pharmacies in the market. So, in its most recent survey, the SHP identified just shy of 300 health system SPs in its sampling. And among those respondents, 71% had been operating for more than seven years. And these aren't just, you know, simple dispensing operations, right? They're increasingly, you know, integrating in their greater health system model. They're supporting, you know, patient access services, medication management, adherence programs, outcomes monitoring, and a lot of care coordination across the patient journey. So really seeing not only are we seeing more health system specialty pharmacies in the space, but more mature programs as well. And then concurrently, the underlying specialty market has expanded dramatically. So I think most people are familiar with the fact that specialty meds are now accounting for more than half of the US pharmaceutical spend.