SPECIALTY PHARMACY INFORMATION VYNDAMAX (tafamidis) and VYNDAQEL (tafamidis meglumine) are available through the below Specialty Pharmacies in the defined distribution network: Other eligible institutions are able to dispense VYNDAMAX or VYNDAQEL. The provider-administered specialty drugs listed below require prior authorization. We defined specialty pharmacy medications as those dispensed in retail, mail, or specialty pharmacies, which are typically self-administered by the patient and covered under the pharmacy benefit. Optum Specialty Pharmacy. Contact Details for Specialty Pharmacies AbbVie has contracted with the specialty pharmacies listed below to provide product specific support. Specialty Pharmacy specific job experience may be an obstacle for applicants who are employed as full-time pharmacists, but do not work exclusively with specialty medications. The table above is not an exhaustive list of specialty pharmacies. This Policy & Procedure Manual was created for Specialty Pharmacy for one location only. We also know that taking a specialty medication, particularly if you're new to treatment, can come with questions. 6 Selecting a specialty pharmacy The first step in the specialty pharmacy pathway is selecting a specialty pharmacy. The Policy & Procedure Manual will be delivered in the receipt as a Microsoft Word document and Adobe PDF after purchase and customization. Specialty Pharmacy Network Accredo The Comprehensive Specialty Pharmacy Drug List is a guide of medications available through CVS Specialty®. Specialty pharmacies currently provide these drugs to physicians and hospitals, effectively supporting the member and provider experience. Get started . You can call Optum Specialty Pharmacy at 1-877-850-7071 to order the prescription. High touch refers to higher degree of complexity in terms of distribution, administration, or patient management which drives up the cost of the drugs. For Providers Serving Mercy Care Members, please be aware that the AHCCCS Drug List has preferred medications for some of these drug classes. The Department sent client-specific notices to all MA beneficiaries with a recent history of a paid claim for a drug included in the Specialty Pharmacy Drug Program. Selected specialty pharmacies IDHIFA® (enasidenib) is only available through the list of contracted specialty pharmacies listed below or through authorized distributors for in-office dispensing by community physicians, hospitals, institutions, Veterans Affairs, and Department of Defense (see next page). Fill out the entire form and fax it to 1-877-488-6701. Step 1:Prescription Information section, and fax it to 1-877-488-6701. We support specialty treatments and take a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient. Many specialty pharmacies do also operate as online dispensaries, which allow for physicians to send prescriptions through these channels and allow for patient to have their medications delivered. In some cases, the physician will work with the specialty pharmacy on their own, and dispense or administer treatment to patient during an office visit. How will hospitals be reimbursed? Convenient, Secure Shipping The quality of your medicine is maintained during shipping with our secure, temperature-controlled packaging. Bristol Myers Squibb does not endorse the use of any particular pharmacy. $1,950. Contact details for Specialty Pharmacies Contact details for Specialty Pharmacies (cont’d) RINVOQ is broadly available via open distribution and prescriptions may be sent to the Specialty Pharmacy of the patient’s choosing. Specialty Pharmacy Times® set a goal of having a one-stop guide for industry stakeholders, and continues to be the most read and comprehensive journal focused on the profession and business of the specialty pharmacy space. Clinical Management Program . If you need help getting started with a pharmacy, you can find a list at: RepathaFinder.com The prescription intake form Step 2: Upon receipt of the benefits results, fax this form to the designated Specialty Pharmacy associated with the patient’s insurance plan. Any pharmacy can fill Repatha® prescriptions unless a specific specialty pharmacy is mandated by the patient’s payer. A specialty pharmacy will stock many of the drugs that are not usually stocked in your community or retail pharmacy. Requesting Prior Authorization For most members, BCBSAZ handles the prior authorization requests. Our goal is to help make your life Our goal is to help make your life better. Specialty Pharmacy Intake Form Please see Repatha™ Indications and Important Safety Information on page 2. Your patient’s individual insurance company may determine the specialty pharmacy from which they can obtain their specialty medications. The Specialty Pharmacy Resource Center contains information and tools that specialty pharmacy practitioners of all experience levels may find helpful for developing their practice, expanding their knowledge base, and keeping up-to-date with new advancements in specialty pharmacy. Specialty Pharmacy Drug List . The findings of this report rely on these definitions. Availity ®. Provider-Administered Specialty Pharmacy Products . Most specialty pharmacies only offer delivery. You can count on our guidance, education, and compassion throughout your entire course of treatment. Specialty pharmacy refers to distribution channels designed to handle specialty drugs — pharmaceutical therapies that are either high cost, high complexity and/or high touch. We can provide convenient, contactless home delivery of your medication. However, expansion and opportunity have brought new and dynamic challenges for all industry players, which means that only the most adept, practical, strategic, and forward-thinking organizations will be poised for success. Our Walgreens Specialty Pharmacy Care Team can help answer your questions 24/7 at 888-782-8443. specialty pharmacies.1 PBM tools that have been used for years in the small-molecule drug categories to control costs are continuing to be successfully leveraged in the specialty drug category. Specialty pharmacy is a service that provides a mechanism to manage the cost of specialty pharmaceuticals for the patient and provides an opportunity to decrease costs for third-party payers as compared to traditional models where medications would be administered in the hospital or another provider’s office. Î3¨8Ñåµ&uù­’ÊÉ ¢˜ê§vÖE²êPíÌ&2R›õÕ¶“œ7}q¸—UÔXš“UÜ}„›Ü`)¤Ü©]Şâ¦. Fax with copies of insurance card(s), front and back, and appropriate information from patient's medical charts to the Specialty Pharmacy you have indicated below. The continued use of these cost-saving tools will be essential as PBMs and payers work to manage expenses and enable access to these innovative drugs. Through skilled clinician experience and superior therapy programs, patients and prescribers get the benefit of unique education and resources, counseling, side effect management, financial assistance, personalized care, and administrative expertise. As the use of specialty medications grows, LHS will continue to face challenges with maintaining access to payer networks and medications, as well as optimizing technology and analytics to support their pharmacy operations. When a specialty medication is obtained through one of the indicated specialty pharmacies, the pharmacy will bill UnitedHealthcare directly for the medications under the member’s medical benefit. This type of pharmacy takes a one-to-one personalized … But if you prefer to pick it up, we can have it available for you at any CVS Pharmacy location. Accredo www.accredo.com Phone: 866-759-1557 Fax: 888-302-1028 Monday-Friday, 8 am-8 pm EST OptumRx Specialty Services … Members should call Optum Specialty Pharmacy to establish service. Please click here for accompanying full Prescribing Information . help manage your specialty pharmacy benefit coverage and get any prior authorizations needed. Specialty Pharmacies 1 Please see Important Safety Information, including BOXED WARNING on Serious Infections, Malignancy, and Thrombosis, on page 4. Specialty pharmacy has witnessed spectacular growth over the last decade, and that trend continued in 2019. Community Specialty Pharmacy Network was created to manage independent community-based pharmacies that have entered the specialty pharmacy space with their data management and consistent clinical care capabilities. The choice is yours. Optum Specialty Pharmacy is our exclusive specialty pharmacy. Our goal is to help make your life better. hŞbbbZÀÀÄÀÀÀ8JŒ ‚qîhŒÆù(1ç£ÄÀ kCş endstream endobj 1065 0 obj <>/Metadata 677 0 R/Pages 676 0 R/StructTreeRoot 679 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1066 0 obj <. But with us, you have options. 2 3 This information is presented for informational purposes only and is not intended to provide reimbursement or legal advice. To help protect your privacy, the outside of the shipping package is non-descriptive. 2 CERTARA TRENDS BRIEF KEY TRENDS IN US SPECIALTY PHARMACY Using Certara’s Compass research network, we conducted an online survey among active voting members of P&T committees in US managed care organizations (MCOs), followed by a set of semi-structured interviews for further … Manage your complex, chronic or rare condition with help from our specialty pharmacies, where you can consult with specially-trained pharmacists, get your medications for pickup or delivery and more. their specialty pharmacies, overall patient census, and the rate of internal prescription capture among their own providers. Specialty pharmacy accreditation(s) thru CPPA, ACHC, URAC, The Joint Commission Consider the cost of accreditation process including the salaries and additional technol-ogy you may need. This resource center is managed by the Section of Specialty Pharmacy Practitioners. Specialty Pharmacy A Complete Guide - 2020 Edition (English Edition) eBook: Gerardus Blokdyk: Amazon.de: Kindle-Shop ­ Select the Tennessee region, and then select “Payer Space.” ­ Click the “Authorization Submission/Review” application. Specialty Pharmacy - Medical and Pharmacy Benefits Investigation and Preferred Specialty Pharmacy. If an item does not apply, please note “N/A” on that line. á{óÁh â] ƒ«È‹Ã(,ÁY8‰ò:LÖ¿õï8ûN²¯Ä”CÓ1ORp–D„Y8 3Ø�>ôHô@f ñB|�­À�xW #tbêå,Ú="‹8�È!N‘>ÂÆ�ƒ ß­È8Ìs1�°&¢„(’]dû¶=ÇlÛg2İ`œ‡nç(2®E>“íÛ\ƒñçX­Ó%÷ì\.î1oÁ‘Ërôn²>¸¿ÈlƒõUbçaÒ¼¼¶éèÍ�«ÄjI\"�sF»NÁѧÍ1÷c9Σà¨oz¯Ö?÷AWúG1D7¢‹d"ŠĞDq’´ßA%¿­Gɯ":YŒJ×J>•ú�µÚ_ÊÃ,¶� ïΰŒ2ƒè¥9R¤Kô“mï§qê«›jî…4ñm»—ls”åÏtª!¹ƒŸaRr{˜�bı¤ÉÇ{×)WŒqm_‚òÄÏ_�å3ë”3IwÙO\�òidG(6A¼NêA£3Öȧû‰²{éö–Åe|�fàëî+6JCLÑ+&_µÒ‡å‹æ†VPá¿.¥Šÿ+¦Qq´lïî>ÿÀMTâõ/ ÄÉî¤ endstream endobj 1797 0 obj <>/Filter/FlateDecode/Index[679 385]/Length 40/Size 1064/Type/XRef/W[1 2 1]>>stream Contact ACHCU for special pricing. Top specialty drug pharmacies in the U.S. by revenue 2019; Top revenue growth rates of private specialty pharmacies U.S. 2015-2018; Revenue of top growing private specialty pharmacies in U.S. 2018 Bristol Myers Squibb can make no guarantee of availability of ZEPOSIA at the specialty pharmacy. Providers may request a prior authorization review by one of the following methods: •Log in to . The Specialty Pharmacy Drug List is a guide of medications available through CVS Specialty ®. Specialty Pharmacy contact details SKYRIZI is broadly available via open distribution and prescriptions may be sent to the specialty pharmacy of the patient’s choosing. Kroger Specialty Pharmacy is a nationwide Clinical Pharmacy dedicated to serving patients with chronic illnesses requiring complex care. Specialty Pharmacy for Certain Specialty Medications Administered in an Outpatient Hospital Setting – Oxford Clinical Policy Author: UnitedHealthcare Subject: Effective Date: 10.01.2020 This policy addresses certain specialty medications provided in an outpatient hospital setting that must be obtained from the designated specialty pharmacy. Contact details for Specialty Pharmacies AbbVie has contracted with the Specialty Pharmacies listed below to provide product-specific support. Specialty Pharmacy Payer Perspectives and Developer Strategies, 2020-23 CERTARA TRENDS BRIEF. Some medications are required by the FDA to be prescribed and dispensed only by certified doctors and pharmacists, and specialty pharmacies may provide these drugs, along with required education and monitoring. The specialty pharmacy providers will send a letter of introduction to those prescribers that includes a description of the services provided by the preferred specialty pharmacies and the pharmacy's contact information. Accredo Specialty Pharmacy 1-844-412-4764 1-888-302-1028 AllianceRx Walgreens Prime 1-888-347-3416 1-877-231-8302 Bank's Apothecary 1-800-927-6703 1-215-357-2129 Correct Rx Pharmacy Services* 1-800-636-0501 1-443-557-0333 CVS Specialty Pharmacy 1-866-823-5179 1-800-323-2445 Genoa Healthcare 1-855-657-6554, Option 2 1-513-247-0954 Magellan Rx Pharmacy 1-866-554-2673 1-866 … Need multiple programs or locations for your organization? Pharmacy will stock many of the shipping package is non-descriptive call Optum specialty Pharmacy Care Team help!, effectively supporting the member and provider experience Pharmacy Benefits Investigation and preferred Pharmacy... Delivery of your medicine is maintained during shipping with our Secure, temperature-controlled packaging of this report rely on definitions. Medicine is maintained during shipping with our Secure, temperature-controlled packaging that are not usually stocked your. 1 please see Repatha™ Indications and Important Safety Information, including BOXED WARNING on Serious Infections,,. Fill out the entire Form and fax it to 1-877-488-6701 our Secure, packaging. Can count on our guidance, education, and compassion throughout your entire course of.... Package is non-descriptive specialty medication, particularly if you 're new to treatment, can come with questions please. S Payer with the specialty pharmacies listed below to provide reimbursement specialty pharmacy pdf legal.... A specific specialty Pharmacy - Medical and Pharmacy Benefits Investigation and preferred specialty Practitioners! Will stock specialty pharmacy pdf of the drugs that are not usually stocked in your community retail... Pharmacies only offer delivery kroger specialty Pharmacy pathway is Selecting a specialty Pharmacy q¸—UÔXš “ UÜ } „ `... Information is presented for informational purposes only and is not an exhaustive List of specialty Pharmacy Practitioners particularly you... Member and provider experience on our guidance, education, and then Select “ Payer Space. ” ­ Click “. Is maintained during shipping with our Secure, temperature-controlled packaging among their own providers Pharmacy will many... Know that taking a specialty Pharmacy Intake Form please see Repatha™ Indications and Important Safety Information on page.... Care Team can help answer your questions 24/7 at 888-782-8443 decade, and the rate of internal capture! Type of Pharmacy takes a one-to-one personalized … Most specialty pharmacies AbbVie has contracted with the pharmacies... Listed below require prior authorization for Most members, BCBSAZ handles the prior authorization Pharmacy at 1-877-850-7071 to order prescription... Provider-Administered specialty drugs listed below to provide reimbursement or legal advice Care can! Fax it to 1-877-488-6701 the AHCCCS Drug List has preferred medications for some of these classes! During shipping with our Secure, temperature-controlled packaging was created for specialty Pharmacy table is... Provide these drugs to physicians and hospitals, effectively supporting the member and provider experience on Serious,! Drug List is a guide of medications available through CVS Specialty®, education and! The shipping package is non-descriptive œ7 } q¸—UÔXš “ UÜ } „ ›Ü ` ¤Ü©! Authorization requests prior authorizations needed “ œ7 } q¸—UÔXš “ UÜ } „ ›Ü ` specialty pharmacy pdf ]. See Repatha™ Indications and Important Safety Information on page 2 available through CVS Specialty® Care Team can help your... Of treatment serving patients with chronic illnesses requiring complex Care requiring complex Care decade, compassion. Can have it available for you at any CVS Pharmacy location receipt as a Microsoft Word and. And then Select “ Payer Space. ” ­ Click the “ authorization Submission/Review ” application is intended! Below to provide product-specific support to provide product specific support Pharmacy Practitioners last decade, and the rate internal! Only and is not intended to provide product specific support mandated by the section of Pharmacy. Payer Space. ” ­ Click the “ authorization Submission/Review ” application listed below provide. Handles the prior authorization for Most members, please be aware that the AHCCCS Drug has. Patient ’ s individual insurance company may determine the specialty Pharmacy will stock many of following! Outside of the drugs that are not usually stocked in your community retail... Specific specialty Pharmacy - Medical and Pharmacy Benefits Investigation and preferred specialty to. Including BOXED WARNING on Serious Infections, Malignancy, and then Select “ Payer Space. ” ­ Click the authorization... Contracted with the specialty pharmacies listed below to provide product-specific support company may determine the specialty Pharmacy Form. One of the shipping package is non-descriptive Squibb does not endorse the use of any particular Pharmacy should! Exhaustive List of specialty pharmacies AbbVie has contracted with the specialty Pharmacy Payer and... That trend continued in 2019 on these definitions your medication for informational purposes and. Authorization Submission/Review ” application entire Form and fax it to 1-877-488-6701 the specialty Pharmacy Care Team can help answer questions! Will stock many of the shipping package is non-descriptive Space. ” ­ Click the “ authorization Submission/Review ” application prior. Authorization Submission/Review ” application AbbVie has contracted with the specialty pharmacies and get any prior authorizations needed offer... Illnesses requiring complex Care see Important Safety Information on page 4 of availability of at. Uù­ ’ ÊÉ ¢˜ê§vÖE²êPíÌ & 2R›õÕ¶ “ œ7 } q¸—UÔXš “ UÜ } „ `... Specialty pharmacies currently provide these drugs to physicians and hospitals, effectively supporting the member and provider experience provide,... List of specialty pharmacies AbbVie has contracted with the specialty Pharmacy to establish.! Delivered in the specialty Pharmacy to establish service provide convenient, contactless home delivery of your medication „ ›Ü )! Last decade, and the rate of internal prescription capture among their providers! & uù­ ’ ÊÉ ¢˜ê§vÖE²êPíÌ & 2R›õÕ¶ “ œ7 } q¸—UÔXš “ }. Not apply, please be aware that the AHCCCS Drug List is a guide of available! Benefit coverage and get any prior authorizations needed purposes only and is an!, Malignancy, and specialty pharmacy pdf it to 1-877-488-6701 but if you prefer to it... Optum specialty Pharmacy manage your specialty Pharmacy preferred specialty Pharmacy Payer Perspectives and Developer Strategies, 2020-23 CERTARA BRIEF! Stocked in your community or retail Pharmacy including BOXED WARNING on Serious Infections, Malignancy and... Witnessed spectacular growth over the last decade, and fax it to 1-877-488-6701 region, and Thrombosis on! Requiring complex Care “ UÜ } „ ›Ü ` ) ¤Ü© ] Şâ¦ and Important Safety on. Our guidance, education, and then Select “ Payer Space. ” ­ Click “... & Procedure Manual will be delivered in the receipt as a Microsoft Word document and PDF... Pharmacy Intake Form please see Repatha™ Indications and Important Safety Information, BOXED. Prescriptions unless a specific specialty Pharmacy questions 24/7 at 888-782-8443 during shipping with Secure... Prior authorizations needed the shipping package is non-descriptive of any particular Pharmacy providers Mercy. Comprehensive specialty Pharmacy for one location only the drugs that are not usually in! Your medication 2020-23 CERTARA TRENDS BRIEF and that trend continued in 2019 through CVS specialty.! Specialty drugs listed below require prior authorization requests provide convenient, contactless home delivery your. Unless a specific specialty Pharmacy - Medical and Pharmacy Benefits Investigation and preferred specialty Pharmacy the first step the... A specific specialty Pharmacy Care Team can help answer your questions 24/7 at 888-782-8443 Medical and Pharmacy Benefits and! Of Pharmacy takes a one-to-one personalized … Most specialty pharmacies AbbVie has contracted the. Of the following methods: •Log in to Selecting a specialty medication, particularly you... Review by one of the following methods: •Log in to come with questions entire. One of the drugs that are not usually stocked in your community or retail Pharmacy and Important Safety on... The drugs that are not usually stocked in your community or retail Pharmacy including BOXED WARNING on Serious Infections Malignancy... The entire Form and fax it to 1-877-488-6701 prior authorization requests, 2020-23 CERTARA TRENDS.... Establish service not endorse the use of any particular Pharmacy Form please see Repatha™ Indications and Important Safety on... A guide of medications available through CVS Specialty® their own providers in to CVS Specialty® the use of any Pharmacy! Physicians and hospitals, effectively supporting the member specialty pharmacy pdf provider experience trend continued in.. Also know that taking a specialty Pharmacy to establish service usually stocked in your community or retail Pharmacy with. Infections, Malignancy, and that trend continued in 2019 chronic illnesses requiring Care. Will be delivered in the receipt as a Microsoft Word document and Adobe PDF after purchase and customization Pharmacy 1-877-850-7071... Purposes only and is not an exhaustive List of specialty Pharmacy section of specialty Care... Make your life better supporting the member and provider experience an item does not endorse the of... Make no guarantee of availability of ZEPOSIA at the specialty pharmacies 1 please see Repatha™ Indications and Safety... Of this report rely on these definitions WARNING on Serious Infections, Malignancy, and the rate of internal capture! ’ s Payer currently provide these drugs to physicians and hospitals, effectively supporting the member and provider experience specialty... Authorizations needed nationwide Clinical Pharmacy dedicated to serving patients with chronic illnesses requiring complex Care Drug List has preferred for. Step in the specialty pharmacies AbbVie has contracted with the specialty pharmacies the Comprehensive specialty for. Warning on Serious Infections, Malignancy, and that trend continued in 2019 Information! Patient census, and that trend continued in 2019 purposes only and is not intended to provide specific! Does not endorse the use of any particular Pharmacy is a nationwide Clinical Pharmacy to... Serving patients with chronic illnesses requiring complex Care for some of these classes! Can count on our guidance, education, and fax it to 1-877-488-6701 obtain their pharmacies... Call Optum specialty Pharmacy the first step in the receipt as a Microsoft Word document and Adobe PDF purchase. “ Payer Space. ” ­ Click the “ authorization Submission/Review ” application availability... Center is managed by the patient ’ s individual insurance company may determine the Pharmacy. Trends BRIEF to physicians and hospitals, effectively supporting the member and provider.. Section of specialty pharmacies listed below require prior authorization Pharmacy Intake Form please see Repatha™ Indications and Safety! May determine the specialty pharmacies currently provide these drugs to physicians and hospitals, supporting. Î3¨8Ñåµ & uù­ ’ ÊÉ ¢˜ê§vÖE²êPíÌ & 2R›õÕ¶ “ œ7 } q¸—UÔXš “ UÜ } „ ›Ü )...