Specialty Pharmacy Customer Spotlight: Encompass RX

By AmerisourceBergen |

Here's what we love about this account:

Three young, entrepreneurial pharmacists banded together in 2012 with a novel approach to specialty pharmacy. They had firsthand knowledge of “big box” specialty pharmacy operations moving toward contracted lives in a way that added no real value to patients or physicians. Unafraid to take some risk, they countered with a patient/physician-centric model, convinced that was the path to capture open business in the market.

A mere five years later, they’ve been proven resoundingly correct, evidenced by the $30 million in specialty medications Encompass RX orders each month from AmerisourceBergen.

The company’s approach focuses on directly employing clinical pharmacists to work with physicians and patients — along the way, providing resources needed to ensure approval, affordability and deliverability of desired specialty medications.

The business started with specialty treatments for hepatitis C and then gradually moved on to cover rheumatology, dermatology, transplant and several other disease states. Geographically, Encompass RX has expanded from the metro Atlanta area up the eastern seaboard and as far away as Washington state, with a new California facility in the plans.

“We found a model that worked, and it has allowed us to grow rapidly,” explains John Olsen, co-CEO. “The impetus was to do what the bigger guys do, but better.”

Olsen, who’s been a pharmacist for 15 years, now co-directs and oversees all aspects of pharmacy operations, executive management, sales and marketing, and clinical services. He recently shared his perspective on the specialty pharmacy marketplace in the following Q&A.

Q: What is the Encompass RX mission in the healthcare market, and how is it different from a traditional specialty pharmacy operation?


A:
Our mission is impacting health outcomes positively through personalized, cohesive clinical care.

We believe Encompass RX is more clinically focused than a traditional specialty pharmacy because our pharmacists are deeply embedded in the process. We currently have 22 clinical pharmacists in one facility and are in the process of hiring four more.

Every time a patient is referred to us, they’re going to be speaking to a pharmacist who will be handling their case. We’re going to help them with things like prior authorization or financial assistance. Regardless of whether the patient fills at our pharmacy or is restricted to another network, we’re here for them.

A true specialty pharmacy should be part of a patient’s integrated healthcare team, and that’s exactly how we operate. Unlike some traditional specialty pharmacies that basically just ‘lick, stick and ship,’ we’re wholeheartedly involved in patient care so that we can directly impact patient outcomes.

We’re also highly focused on efficiency here inside the pharmacy, with an eye toward being a partner for payers.

Q: In your view, what is the most important aspect of specialty pharmacy care?

A:
Providing clinical value and patient advocacy. Our job working in a specialty pharmacy is to make sure that the patients referred to us and their providers are given the tools they need to positively impact these patients’ health outcomes. Improving patient adherence would be an example of that. Ultimately, we’re here to improve outcomes.

Q: How do you view the pharmacist’s role in managing specialty pharmacy patients?

A:
The pharmacist’s role doesn’t begin or end with the actual dispensing of the medication. Our clinical pharmacists are an integral part of each referred patient’s healthcare. They’re involved in helping the physician choose the right therapy, the right dose or even the right duration of the medication — all they way to providing a direct utilization review for the patient — and being a source of drug and disease information.

Our pharmacists serve as advocates for patients and providers to ensure that medication is accessed quickly, but also that, through therapy, patients remain adherent and compliant, and side effects are managed appropriately.

Q: Encompass RX was the fastest growing company in Georgia for two years running. You’re now licensed in 41 states and plan to cover all 50 states by the first quarter of 2018. How will you continue to scale up?

A:
It’s important to have a wholesaler we feel comfortable with, not only in providing credit needed for growth, but also to quickly provide access to medications at fair prices when new drugs hit the market

Q: Given the strong growth trends in specialty pharmaceuticals and biosimilars, how will those areas impact specialty pharmacy?

A:
Drug pricing is in the forefront of many people’s minds, especially members of Congress. We should continue to see an increase in competitive pricing strategies from pharma and in new markets. Biosimilars have been delayed mostly by litigation, and we don’t see any immediate change in the near future in that. However, we will continue to see pharma companies with brand-name drugs get more competitive.

Additionally, health outcomes, accreditation, data reporting and risk-based contracting will all continue to gain importance. We’re seeing more innovative ways for payers to save money and for specialty pharmacy to gain access to networks. Specialty pharmacies need to be agile and adaptable to stay competitive in the market as it changes. 

Q: What types of data analysis will be essential to further growth?

A:
Data sharing among pharma, payers and pharmacies is becoming the norm rather than the exception. That data can range from dispensing files, to files as complex as de-identified patient information regarding demographics, severity of disease, outcomes and adherence rates.

Over time, data will continue to get more and more robust. We have contracts now with 100 data points. The ability for specialty pharmacy and wholesalers to provide data back to payers and pharma — to give them the visibility they want and deserve for their products and patient lives — will be extremely important in closing the loop in healthcare.

Q: What is your overall vision for Encompass RX moving forward, and how will AmerisourceBergen help you achieve it?

A:
While we’re pursuing more growth — not only geographic, but also in new therapeutic areas — AmerisourceBergen provides capabilities to help us along that path. The future is in technological advancement as well as data collection and reporting. They’ve also shown willingness to get innovative in the procurement and delivery of medications. Their ability to partner as teammates to show value to payers and pharma alike will be key in helping us achieve our goals.