Cloe Talamini serves as a pharmacy specialist and senior healthcare business analyst at BroadJump, an expense management company.
Before joining BroadJump, Ms. Talamini worked at the inpatient pharmacy of Arlington, Texas-based Texas Health Resources, where she managed inventory, purchased products, executed cost savings initiatives and analyzed data to improve group purchasing organization contracts and the 340 B program.
Becker's Hospital Review recently asked her to explain some of the major pharmacy trends, discuss the main cost drivers in pharmacy and share a piece of advice for other pharmacy leaders.
Here's what she had to say:
Editor's Note: Responses have been lightly edited for length and clarity.
Question: What are some of the major pharmacy trends hospital leaders need to know?
Cloe Talamini: Pharmacy is always evolving, and hospital pharmacies must stay in trend to keep up with the demanding market and constant rise of healthcare costs. With the influx cost of specialty drugs, the pharmacy is in a constant juggle to keep expenses low and keep the budget on track. Not to mention, monitoring drug shortages and the expenses associated with supplemental drugs, or even the cost of time to provide a solution to these hospital shortages. Pharmacies must start implementing strategies to monitor and track these added expenses and problems. Hospital pharmacies now are developing a standard formulary for common generics, as well as implementing procedures to watch for non-formulary items, to help control unnecessary expenses. They are also increasing their attention on 340B performance. Another focus is moving to biosimilars of biologics to bring down outrageous costs. With all these inflating costs, pharmacies must utilize data in order to increase performance and lower spend. The goal is to continue to monitor and determine what impact changes on cost and affordability have within the pharmacy.
In short the eight trends to know are:
- Increased specialty drug cost
- Drug shortages
- Creating a standard formulary
- Creating a plan for nonformulary items
- 340B performance
- Biosimilars of biologics
- Using data to increase performance and lower cost
- Learning to manage the high dollar expenses
Q: Can you describe some of the differences between what drives pharmacy costs up on the inpatient versus outpatient side?
CT: The constant struggle with drug shortages can have a major impact on inpatient pharmaceutical spend. These shortages cost hospitals extra expenses by causing the hospital to overcompensate on buying similar drugs, as well as the extra time spent compounding or even repackaging.
Another known impact on hospital systems is the adherence from facility to facility on the formulary. Facilities are buying off-contract pharmaceutical items that add multiple unnecessary expenses, causing extra cost to the budget.
The outpatient pharmacies that are constantly arising for hospitals systems usually focus on specialty areas of pharmaceuticals, such as oncology drugs. These drugs are usually some of the highest cost drugs on the market, which is part of what is driving the budget for these pharmacies. If outpatient pharmacies can leverage the costs for these items, they would be able to realize significant savings.
Q: What specific drugs coming in the near term are you keeping an eye on? Why?
CT: Therapeutic sections of pharmacy, including oncology drugs, anti-infectives, specialty drugs and orphan drugs are some of the highest costing drugs due to brand-only medications that do not always have exact equivalences in the market that can be medically necessary for patients. Being able to monitor trends for these items would give a huge advantage to the hospital system.
Q: If you could pass along one piece of advice to a hospital pharmacy leader, what would it be?
CT: Hospital pharmacy leaders need to start focusing on utilizing their data to control costs within the pharmacy. The ability to understand exactly where they stand against their peers based on market share and spend will allow them to act on high-dollar pharmaceutical items. Ultimately, having the leverage to manage costs and evaluate trends on the drugs that impact the greatest portion of the pharmacy budget will help in achieving maximum savings for a hospital's pharmaceutical costs.