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Hospitals face specialty pharmacy challenges with insurer competitors

Well being programs are more and more opening their in-house specialty pharmacies to drive higher affected person outcomes and bolster potential income, however they face stiff competitors from payers who additionally see the identical alternative and have the facility to maintain their members’ pricey and complicated medication inside subsidiaries and associates.

That is the case on the College of Illinois Well being Sciences System, the place Matthew Rim works in a workforce of three pharmacists to run their in-house operation, managing complicated and really costly medication for circumstances like rheumatoid arthritis, most cancers and Hepatitis C. He mentioned they find yourself solely having the ability to fill the prescriptions of about half of their sufferers on specialty drug remedies.

“We are literally dropping sufferers to these vertically-integrated payers, or PBM-owned specialty pharmacies, as a result of we aren’t capable of get contracted with them, and there are restrictions that we’ve

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