As part of our COVID-19 Impact Series, we have been exploring potential impacts to our nationwide network of health system specialty pharmacies. Read More >

Case Studies

Regional Health

Gaining access to a limited distribution network

Developing data capabilities to build business readiness

“Developing our data capabilities to gain access to this limited-distribution network has allowed us to serve our community more effectively, capture revenue that was previously lost, and strengthen our specialty pharmacy.”

Executive Summary

In February 2015, the Excelera specialty pharmacy network was selected to participate in Pfizer Inc.’s limited-distribution network for a group of oncology products: Bosulif® (bosutinib), Ibrance® (palbociclib), Inlyta® (axitinib), Sutent® (sunitinib malate) and Xalkori® (crizotinib).

At first, Regional Health, an Excelera member headquartered in Rapid City, South Dakota, was unable to participate in the Pfizer network because it did not have the full complement of data capabilities that the drug manufacturer required. The lost revenue opportunity for Regional Health was considerable; as the home of the John T. Vucurevich Regional Cancer Care Institute, Regional Health is a major provider of cancer treatment in western South Dakota.

Excelera worked with Regional Health to develop the specific data capabilities required and to demonstrate these capabilities to Pfizer.

Challenges

As manufacturers seek to manage the distribution of their specialty drugs, health system pharmacies may be excluded from limited-distribution networks and unable to fill prescriptions written by their own providers.

Solution

Excelera engaged with Regional Health to develop processes and procedures for data collection and aggregation, targeted to Pfizer’s requirements for this limited-distribution network of breast, kidney, and lung cancer drugs. Excelera then helped successfully demonstrate to Pfizer that Regional Health was ready to gain access to these drugs.

Results

Regional Health gained access effective July 1, 2017. By the middle of October 2017, they had already filled eight Ibrance prescriptions and two Sutent prescriptions, resulting in revenue of more than $105,000 in less than four months. For the entire group of drugs, Regional Health estimates it will fill 40–50 prescriptions annually.

This Excelera member now has the means to serve more oncology patients, and serve them better, by providing integrated specialty pharmacy care and greater convenience.



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