When a patient with a rare or complex condition needs a specialty medication, education and assistance are vital parts of filling the prescription. That’s why Accredo, Evernorth’s specialty pharmacy, employs more than 800 specialty pharmacists, who receive ongoing training in the medications that treat specific disease states.
The pharmacists are organized within Accredo’s 15 Therapeutic Resource Centers (TRCs), which specialize in numerous conditions and diseases, including blood disorders, inflammatory conditions, and neurological disorders. Every Accredo patient has access to TRC pharmacists around the clock, every day of the year.
Accredo pioneered the TRC model, said Susan Peppers, Evernorth’s vice president of Pharmacy Practice. “Our TRCs are designed around the concept that patients living with chronic and complex conditions have unique needs and require specialized attention,” she said. “The TRC model allows teams of pharmacists, nurses, dieticians, social workers, patient care advocates, and physician engagement advisors to focus on a limited scope of conditions to develop a heightened understanding about specific diseases, their treatments, and factors that can impact therapy outcomes.”
Susan Peppers, vice president of Pharmacy Practice at Evernorth
As drug therapies continue to advance and standards of care evolve, Accredo’s TRC model follows suit, Peppers said. “Our TRCs continue to lead the way in terms of enhanced interventions that address key issues in the health care space, such as medication nonadherence, overutilization, affordability, disease prevention, education, and drug safety.
Accredo pharmacists provide expertise and as much time as patients need
Accredo’s specialty pharmacists support and educate patients about their medicines, speaking with them for as long and as often as the patient needs. Part of the pharmacists’ role is teaching patients how to administer their medicines, in conjunction with Accredo’s field nursing team and the patients’ physicians. Many of these medicines must be infused into a vein or injected with a syringe.
New specialty pharmacists – or those new to a specific condition – learn from hands-on training and clinical curriculum in a program that can take as long as 8 months to complete. “When TRC pharmacists are enabled to hone their practice in this manner and are provided the necessary tools and resources to make better decisions, patients receive better care, become more confident in their treatment, and are more likely to achieve better outcomes,” Peppers said. The average tenure of a pharmacist assigned to an Accredo TRC is nearly 10 years.
Douglas Drab, an Accredo pharmacist in the Rare Diseases TRC, has found that patients diagnosed with a rare disease need help getting started and staying on their medications. “Oftentimes, patients have questions about their medications and are seeking extra training and support,” he said. Accredo pharmacists commit their time and expertise to help patients learn about their medications and become confident enough to self-administer them when appropriate.
Douglas Drab, specialty pharmacist at Accredo
The administration or handling of these drugs can be complex, even confusing. For example, Drab assists patients with neurotrophic keratitis, a disease that causes the cornea to deteriorate and can lead to blindness if left untreated. Accredo uses overnight delivery services to ship prescription eye drops in coolers with dry ice to ensure their medication remains frozen during shipping and educates patients on how to store it to ensure quality. Each delivery also includes the supplies patients need to administer the medication six times a day, at two-hour intervals, for eight weeks.
Accredo pharmacists and nurses coach patients and caregivers through the proper use of the medication, which requires numerous steps. “A lot of the time, it comes down to educating patients, motivating them, and empowering them to feel comfortable enough to push through, complete their therapy, and realize the full benefits, Drab said.”
A culture of working together that puts patients first
In addition to working directly with patients, Accredo pharmacists collaborate with doctors, nurses, and other members of a patient’s care team. “Our pharmacists will engage prescribers to coordinate the start of care through our concierge pharmacist team, provide updates on therapy initiation and ongoing treatment plans, and discuss barriers to adherence and compliance,” Peppers said. “In addition, our pharmacists alert physicians of any adverse events and discuss mitigation strategies, review potential indicators of disease progression assessed by our clinical model, and provide dosing recommendations when warranted.”
Accredo pharmacists also speak with prescribers to discuss alternatives when a medication is unavailable due to supply issues, said Paula Pairmore, a specialty pharmacist in the Endocrinology TRC. Her focus is on human growth hormones, which are currently in short supply due to manufacturing issues. Pausing therapy for these patients is not an option, because even one missed dose can cause complications for some patients, Pairmore said.
Paula Pairmore, specialty pharmacist at Accredo
When a doctor’s office calls to ask which drugs are available, she checks the patient’s insurance benefit to see what is covered. “I try to avoid any additional hurdles to the patients getting their medication,” she said.
When necessary, she reaches out to coworkers across Accredo for assistance. “I’ve never been a part of such an awesome company, where we work so closely together as a team. We are truly working to raise the standard of specialty care,” said Pairmore, who has been a pharmacist for 29 years.
On every call, her priority is helping people get the medications they need. “Helping patients is truly my passion,” she said.