Donald Mashni, PharmD, right, with David L. Reich, MD, center, and José Almonte, Director, Specialty Pharmacy Call Center.
A new option is now available for Mount Sinai Health System patients and employees who have rare or chronic disorders that require complex medications such as immunotherapy or chemotherapy—the Mount Sinai Specialty Pharmacy. The facility, which opened in June at The Mount Sinai Hospital, helps patients seek insurance approval and financial assistance, and relieves the administrative burden of physicians, with the ultimate goal of improving patient outcomes.
“The Mount Sinai Specialty Pharmacy will offer patient-focused, convenient, and affordable services for all our patients,” says Donald Mashni, PharmD, Director, Specialty and Outpatient Pharmacy, Mount Sinai Health System. Specialty pharmacies dispense complex medications that require special storage and handling and ongoing clinical support and monitoring by specially trained pharmacists.
When patients and doctors present specialty prescriptions to the Mount Sinai Specialty Pharmacy, the pharmacy staff can assume the important tasks of securing insurance approval, financial assistance, and clinical counseling. Pharmacy staff also coordinate delivery to the patient’s home or to the physician’s office. “Our facility will tie everything together,” Mr. Mashni says. “The goal is to keep all patient care inhouse, from diagnosis through post-treatment follow-up. This approach provides thorough and immediate communication among pharmacists and specialists. It also improves the efficiency and accuracy of the medications.”
For example, one commonly prescribed specialty drug is adalimumab, or Humira, an advanced biologic medication for severe Crohn’s disease and rheumatoid arthritis. Patients inject a pre-filled syringe every other week. The drug must be refrigerated, and each syringe must be used in full and injected in the thigh or stomach, in a different spot each time. The patient should not skip a dose or stop taking the medication without consulting a physician or pharmacist. “Adherence to the treatment schedule is critically important,” Mr. Mashni says. “It maximizes the benefit patients get from the medication and improves outcomes.”
Specialty medications once were a niche market. But advances in drug research mean they are available for many more conditions. The U.S. Food and Drug Administration approved 39 new specialty medications in 2018, according to Specialty Pharmacy Times, and because they can be so costly, specialty drugs are expected to account for almost 50 percent of drug spending by 2020, although they represent only about 2 percent of the total prescriptions filled.
The Mount Sinai Specialty Pharmacy is launching services in therapeutic categories that include HIV, hepatitis C, inflammatory bowel disease, rheumatology, dermatology, and oncology. It shares space with the Mount Sinai employee pharmacy in the Annenberg Building and functions like a traditional specialty pharmacy but with the advantage of full integration with Mount Sinai’s hospitals and physicians. The Health System also operates two other specialty pharmacies, which are part of the Institute for Advanced Medicine and specialize in treating patients with HIV. They are the West Village Pharmacy, at the Center for Transgender Medicine and Surgery, and the St. Luke’s-Roosevelt Outpatient Pharmacy in the Samuels Clinic at Mount Sinai West.
A new Call Center, adjacent to the Mount Sinai Specialty Pharmacy at The Mount Sinai Hospital, is centralizing all of the Health System’s specialty pharmacy services and fulfillment, with Call Center staff coordinating prior authorization, financial assistance, and delivery of medications. These services are essential as the Mount Sinai Specialty Pharmacy is seeking accreditation from URAC, the gold-standard accrediting body for specialty pharmacies. URAC accreditation will allow the pharmacy to gain access to more limited-distribution drugs and get contracts with more insurance plans.
“The Specialty Pharmacy is enabling Mount Sinai to provide seamless service for patients with complex and chronic illnesses, from diagnosis through treatment and long-term aftercare,” says David L. Reich, MD, President and Chief Operating Officer of The Mount Sinai Hospital, and President of Mount Sinai Queens.