Friday, December 14, 2018

Three Reasons to Join the Industry-Wide Effort to Speed Time-to-Therapy for Specialty Pharmacy

Today’s guest post comes from Lee Ann Stember, President and CEO of the National Council for Prescription Drug Programs (NCPDP).

Lee Ann discusses the crucial importance of getting patients timely access to specialty therapies. She invites Drug Channels readers to participate in NCPDP’s specialty pharmacy work group and its four task groups. Your participation will help establish and refine standards that will benefit patients and all industry participants.

It's simple. Create an account at and then select your preferred task groups. You can also click here to register for upcoming NCPDP meetings.

Read on for Lee Ann’s insights and to get more information about NCPDP’s specialty pharmacy task groups.

Three Reasons to Join the Industry-Wide Effort to Speed Time-to-Therapy for Specialty Pharmacy
By Lee Ann Stember, President and CEO of NCPDP

Imagine this: You or a loved one, after sudden onset or ongoing symptoms, is finally given a medical diagnosis. The diagnosis may be cancer, hepatitis, multiple sclerosis or another complex or chronic disease that requires a specialty medication. Your reaction may be swift and proactive or move down the path of K├╝bler-Ross’ five stages of grief. Meanwhile, it is the responsibility of the care provider to take that next important step and recommend drug therapy. From this point forward, there is a veil of uncertainty that surrounds the patient journey.

There are several paths for processing a specialty medication and the lack of standardization adds to the uncertainty. For example, at the outset, the ordering physician may not know which pharmacy can handle the prescription, and therefore contacts multiple pharmacies. The patient is contacted by those pharmacies, asked for insurance coverage information.

Then there are a slew of other manual processes such as coordinating prior authorization, appeals, determining copay, payment assistance, and so on. What’s most egregious is that it can take days, weeks or even months for you or your loved one to get that specialty medication - widening the gap between diagnosis and treatment and threatening patient health outcomes. This is not acceptable. Reason #1 is your personal connection to this issue, and you’re not alone.

Driven by industry need and demand, NCPDP established Work Group 18 Specialty Pharmacy six months ago; the work group has attracted attention and participation from across the industry by a variety of professionals involved in specialty pharmacy. But that’s not enough; in order to develop comprehensive transactions for specialty pharmacy, we need more people, more perspectives from people like you, your colleagues and business partners.

If the patient journey isn’t compelling enough to make the decision to get involved, consider the universal business goal of access. All stakeholders involved in specialty medications are focused on enabling safe access to these therapies. The administrative efficiencies gained through standardization are so robust in pharmacy, unless you handle specialty medications, you take for granted the swift time to fill enabled by standardized industry transactions for eligibility verification, claim and service billing, predetermination of benefits, prior authorization, information reporting and ePrescribing. Reason #2 is your business driver, which may be anything from expanding your reach to streamlining administrative costs.

We hear it all the time – our members tell us they are here because it is part of their job and they are able to learn more about how the industry functions, or they have a business interest in the development or enhancement of a transaction. Across the board though, they are driven by their personal passion for the work.

As one person said, “This is the one way I can put my experience and skills to good use to make the experience of healthcare easier for patients and their care providers. NCPDP standards are always evolving and improving and it feels good to know that I am part of this special group of people that makes it happen.” Reason #3 is you can make a difference in people’s lives today, and for generations to come.


If you’re not familiar with NCPDP or a work group, you’re not alone. Many of our specialty pharmacy work group participants are here because they understand the complexities and want to help. They are people like you and me, from every corner of the industry.

NCPDP work groups meet quarterly, in-person, at locations across the country. These face-to-face meetings are important and fundamental to our collaborative, consensus-building process.

Today, there are four task groups under Work Group 18 Specialty Pharmacy. Task groups usually meet two or three times a month via teleconference. The task groups are:
  • Specialty Pharmacy Data Exchange Task Group;
  • Specialty Requirement for ePrescribing Task Group;
  • Benefit Coverage Identification Task Group; and
  • Stakeholder Outreach and Education Task Group.

Task group calls are open to NCPDP members and non-members, and you may join a task group at any time.

Here’s how: Go to to create a new account, select the task groups you want to join and when you click “register” you will be able to access call times and meeting notes.

Work group meetings are also open to NCPDP members and non-members. Registration provides access to all work groups meeting during the event, not just the Specialty Pharmacy work group.

Join us at our next quarterly work group meeting, February 6 to 8, at the Hyatt Regency San Antonio in Texas. Plan to also attend our May work group meetings, May 5 to 6, which immediately precede NCPDP’s 2019 Annual Technology & Business Conference at the Westin Kierland Resort & Spa in Scottsdale, Arizona. Register today at

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