Newer posts → November 15, 2012
CINCINNATI and LAKE MARY, Fla., Nov. 15, 2012 /PRNewswire via COMTEX/ — The Kroger Co. (NYSE: KR) today announced it will acquire the outstanding shares of Axium Pharmacy Holdings, Inc., a leading specialty pharmacy, to create a merger of the two companies.
Founded in 2000, Axium provides drug therapies and patient-support services to treat chronic, genetic and other complex medical conditions such as cancer, Hepatitis C, Rheumatoid Arthritis, Multiple Sclerosis and numerous other chronic care conditions. This partnership gives Kroger significantly enhanced capabilities to serve customers who require complex drug therapies, and to deliver those therapies at greater value to customers and insurance payers.
Financial terms were not disclosed.
“Kroger and Axium are a strategic fit as we look to enter the high-growth specialty pharmacy business,” said Lincoln Lutz, Kroger’s vice president of corporate pharmacy. “The combination of Axium’s expertise and Kroger’s 1,950 pharmacy locations, 91 Little Clinic locations, and pharmacists who provide health coaching, biometric screening and other wellness services will deliver positive health outcomes for our patients, cost savings for insurance payers, and unique services for physicians.” Strong Growth Opportunity Specialty pharmacy is the primary area of growth in pharmaceuticals. Revenue for specialty drugs has grown from $17 Billion in 2000 to $104 Billion in 2011, and is projected to grow to $135 Billion in 2014. In 2011, 80% of new drugs approved by the FDA were specialty drugs. Currently more than 700 specialty drugs are in the pipeline for approval.
“This partnership supports Kroger’s long-term growth plans, with strong return on invested capital,” said Rodney McMullen, Kroger’s president and chief operating officer.
Kroger announced a new long-term growth strategy at an investor’s conference in October.
Axium Healthcare Pharmacy Headquartered in Lake Mary, Florida, Axium is one of the nation’s largest independent providers of specialty pharmacy services, offering a range of clinical services to patients with complex chronic conditions. Through its additional pharmacy locations in Puerto Rico, Tennessee and Mississippi, Axium provides comprehensive specialty pharmacy services to patients throughout the United States and Puerto Rico.
Axium seamlessly addresses the clinical, administrative and financial needs of patients, referring physicians, insurance payers and pharmaceutical manufacturers.
For patients, Axium increases medication adherence and enhances the overall quality of patient care through personalized education and treatment, 24/7/365 clinical support and side effect management; For insurance payers, Axium delivers cost effective care management programs and data-driven clinical outcomes; For manufacturers, Axium provides product training for patients, side effect interventions and reporting, and increased medication adherence; and For physicians, Axium improves coordination of patient care through insurance eligibility verification, product consultation, patient monitoring, and clinical interventions to minimize side effects and avoid adverse drug interactions.
Axium will continue to operate as an independent company within the Kroger family.
“We are excited to partner with Kroger to deliver specialty pharmacy services to their customers,” said Mark Montgomery, Axium’s president and chief executive officer. “We believe this relationship will create efficiencies that will reduce costs, drive growth and improve the overall quality of our combined healthcare services.” Mr. Montgomery will continue to lead Axium. He has been with the company for nine years, the last six as president and CEO. With more than 25 years of healthcare leadership experience, he has held instrumental management roles with multiple leading nationwide specialty pharmacy providers.
“We are very excited to welcome Axium’s leadership team and all 160 current associates to the Kroger family,” said Mr. Lutz. “Mark and the team have built a great company that is positioned for growth.” The transaction is contingent on typical conditions of closing, including any required approval of regulatory authorities. Edge Healthcare Partners, LLC served as Axium’s financial advisor for the pending merger.
Kroger, one of the world’s largest retailers, employs more than 339,000 associates who serve customers in 2,425 supermarkets and multi-department stores in 31 states under two dozen local banner names including Kroger, City Market, Dillons, Jay C, Food 4 Less, Fred Meyer, Fry’s, King Soopers, QFC, Ralphs and Smith’s. The company also operates 788 convenience stores, 342 fine jewelry stores, 1,124 supermarket fuel centers and 37 food processing plants in the U.S.
Recognized by Forbes as the most generous company in America, Kroger supports hunger relief, breast cancer awareness, the military and their families, and more than 30,000 schools and grassroots organizations. Kroger contributes food and funds equal to 160 million meals a year through more than 80 Feeding America food bank partners. A leader in supplier diversity, Kroger is a proud member of the Billion Dollar Roundtable and the U.S. Hispanic Chamber’s Million Dollar Club.
SOURCE The Kroger Co.
November 14, 2012
The Evolving Specialty Marketplace
Trends that affect how pharmacies do business
by Joseph Morse, President and COO, Therigy
The world of specialty pharmacy is continually changing and growing. Accreditation has become a common occurrence, with payers requiring specialty pharmacies to be accredited by one of three key organizations — ACHC, The Joint Commission or URAC. In recent years, the trend has shifted from ACHC toward URAC accreditation since payers want providers aligned with their own accreditation.
The government’s programs are resulting in greater integration of services among health systems, physicians and specialty pharmacies. As of July 2012, 89 new accountable care organizations had entered into agreements with the Centers for Medicare & Medicaid Services. By doing so, these ACOs take responsibility for the quality of care they provide to Medicare patients in return for the opportunity to share in savings realized through high-quality, well-coordinated care. The number of ACOs is certain to grow in the future and result in greater integration of the specialty pharmacy services.
Medications, their means of administration and the complexities of treatment also continue to have an impact on specialty pharmacies. This year saw the introduction of some exciting, new drugs.
One example is Krystexxa for refractory chronic gout. “Since there’s a high degree of anaphylaxis with this intravenous drug, it requires a lot of support and must be administered in a health care setting where allergic reactions can be treated,” says Todd Weber, managing partner at Specialty RN Source. “The drug isn’t very well-known, but it’s pretty much the only therapy available for patients who have exhausted all other options and still have high uric acid levels.”
Benlysta, the first new treatment for patients with lupus in 50 years, also made its debut. Typical treatment for lupus has included the use of steroids, anti-inflammatories and anti-malarial drugs to target and control symptoms. Benlysta, a B-lymphocyte stimulator-specific inhibitor administered via IV infusion, affects the survival of B cells. “Since the potential for anaphylaxis exists with this drug, it is given in a physician’s office or other supervised setting,” explains Kathy McKay, RN, BSN, director of nursing with Specialty RN Source. “Once the patient is stabilized on therapy and tolerance is known, the physician may approve infusions at home.”
In May 2012, the FDA approved Elelyso for long-term enzyme replacement therapy for adult patients with Gaucher’s disease Type 1, a rare genetic condition. This medication is manufactured through recombinant DNA technology using a plant-cell-based process, specifically carrot plant root cells. Elelyso is administered via IV infusion over one to two hours every two weeks.
Within the next year or so, Biotest Pharmaceuticals hopes to introduce Bivigam, a polyspecific immunoglobulin for the treatment of antibody deficiencies. In August, the U.S. Food and Drug Administration raised no questions on the clinical efficacy and safety of the ready-for-use 10 percent solution, stabilized by glycin. Biotest is currently planning a new, additional validated test system for the detection of thrombogenic activity.
The impact of new drugs on specialty pharmacies
Biotech and specialty drugs such as these increasingly require infusion by a nurse clinician. In response, some specialty pharmacies have begun expanding their infusion capabilities and services by establishing or expanding their specialized infusion nursing capabilities.
This only makes sense because the marketplace has and will continue to reward those pharmacies that become best-in-class for a specific disease state. Manufacturers want the greatest competency to manage drugs in patients. Physicians need the knowledge and services pharmacies provide to help manage these patients. PBMs are also relying on specialized pharmacies, as evidenced by a recent RFP sent out by a national PBM for an oncology-specific network comprised of best-of-class pharmacies.
While opportunities for established specialty pharmacies continue to grow, so does the number of competitors. In some cases, health care companies with pharmacies and an infusion division are expanding the infusion division or spinning it off. Some entrepreneurs who sold pharmacies several years ago are re-entering the market now that their non-competes have expired, increasing the number of specialty pharmacies nationwide.
With so many choices, manufacturers are challenged to figure out how to differentiate pharmacies, tier them to qualify them and align their product needs with the capabilities of pharmacies. Accreditation is often a key criterion they use.
That takes accreditation from an option to a necessity. As a part of accreditation, pharmacies must have a systematic therapy management program to assess patients who self-administer meds. To meet patients’ holistic needs, specialty pharmacies must expand nursing in the home and better coordinate the continuity of care with prescribers. Technology will play a key role as specialty pharmacies advance the management of specialty therapies.
Mobile devices are now commonplace with all socioeconomic and age groups, enabling direct communication via texts and emails to promote drug education on side effects and compliance. Better customer support, as well as the timing and delivery of medications, will grow in the future with the advent of new ways of using these devices.
In addition, pharmacies will rely more on technology to reduce capital and operating expenses by leveraging cloud-hosted system application models such as therigySTM. Through these means, pharmacies will be able to provide more effective, higher-quality patient therapy without investing in expensive hardware.
The need for additional certifications
While accreditation is essential for specialty pharmacies, additional certifications for clinical staff members may also be required. The newly formed Immunoglobulin Nursing Society (IgNS) is on track to develop a certification program for immunoglobulin administration and the management of patients receiving therapy. This past August, IgNS held its inaugural meeting to advance the knowledge and skills of nurses and other health care professionals in the clinical practice of Ig therapy. Their goal is to develop the standards of care and best practice guidelines for a nationally recognized certification program.
As McKay states, “Immunoglobulins are used to treat a diverse group of patients and disorders, so nurses require a specialized and expanded knowledge base and skill set. A certification program ensures that a clinician has met core educational requirements and possesses the skill and practices according to the standards of care. As new and more specialty infusion therapies emerge, we may see additional certifications emerge as well.”
However, nurses may not be the only professionals who’ll need new certifications. In March of this year, the Board of Pharmacy Specialties announced it would be conducting delineation studies in cardiology and infectious diseases. If the studies provide information suggesting these two areas should be recognized as specialty practices in pharmacy, BPS will issue a call to the profession for a petition for new specialty recognition. The process leading to the administration of a certification exam will take approximately three years to complete.
In May, BPS completed a review of role delineation studies of critical care pharmacy and pediatric pharmacy and decided enough evidence exists to warrant petitions for BPS consideration of these two areas as possible pharmacy specialties. It plans to double the number of specialties for which pharmacists can become BPS board-certified by 2016.
In August, the Specialty Pharmacy Certification Board announced it had contracted with SeaCrest Company to launch a new professional certification program for specialty pharmacists. The Certified Specialty Pharmacist credential will validate pharmacists’ expertise in all specialty pharmacy practice settings. The group also plans to develop therapeutic category subspecialty “endorsements” that will require additional assessment testing once a pharmacist has been certified, as well as differentiated certifications for nurses and other health care professionals.
Specialty pharmacy is the fastest-growing segment of the industry, and with the aging of America and a plethora of drugs coming to market, the forecast is for continued, rapid growth. However, challenges do exist, from increased competition to the need for differentiation to finding new ways of doing business better and more economically. To prosper, specialty pharmacies need to move now to prepare for the days ahead
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October 3, 2012
Technology has significantly changed the level of care that is available to patients receiving therapies for rare chronic diseases. Traditional therapy management programs were comprised of a multitude of various service providers that were used by manufacturers to provide reimbursement assistance, patient assistance, pharmacy services and clinical services. Each of these service providers may have used different technology platforms to manage the same patient. Often times, multiple systems did not run on the same platforms, thus making it difficult to integrate them. This resulted in data loss and/or improper transfer of data from provider to provider. Ultimately the goal of any and all service providers involved in the care of patients with rare chronic diseases should be to maximize the level of patient care.
One potential solution would be to centralize all of the activities around the care of the patient at a Patient Service Center (PSC). The Patient Service Center will communicate with all of the other service providers, but will serve as the central management center for the patient. The important thing to understand is that any contact the patient makes with the PSC, will be through their Therapy Manager. This model would ensure that the start of care begins with a clinical focus and ends with a clinical focus. Upon intake, the patient will be assigned to a Therapy Manager and will be followed by the Therapy Manager for the life of the therapy. Each of the Managers will be credentialed Registered Nurses that have been trained exclusively in the competencies of the specific disease. The PSC will use an open source technology platform that can be easily integrated with the systems that are used by the other service providers (e.g. reimbursement, PAP, Pharmacy). When the Therapy Manager needs to check the patient’s benefits, they will have direct access to the system of the specific service provider and will be able to communicate relevant information to the patient(s). The key benefit of this model is that patients that require a high touch approach will have a single point of contact within the PSC. That single point of contact is a health care provider that has access to any relevant information pertaining to the patient’s therapy through an integrated technology platform.
The key to the success of this model is contingent upon selecting the proper technology platform. The system used by the PSC must be able to communicate back and forth with all of the service providers that have been sourced by the manufacturer to provide patient care. Once the systems have been properly integrated and tested, proper training is essential to the success of the model. The RNs managing the patients at the PSC must be thoroughly trained on how to effectively and efficiently utilize the software system. This is a time consuming process, but the single point of contact model has the potential to greatly enhance the quality of care that is currently being delivered to high touch patients suffering from rare chronic diseases. If patients with rare chronic diseases have the opportunity to be followed by a healthcare provider for the lifetime of their therapy or by an employee of a traditional HUB services provider, which option would they likely choose? By having a Therapy Manager, follow the patient as the single point of contact, this model may provide manufacturers of rare chronic diseases with the opportunity to create a competitive advantage in their respective spaces. Everything hinges on the ability of the Patient Service Center to leverage the technology that is available today to create efficient and effective lines of communication between multiple service providers.Posted in Uncategorized | Leave a comment
October 1, 2012
The Specialty Pharmacy Leadership Congress is a two day invitation-only gathering of industry leaders followed by a 5k fundraiser for cancer care. Pharmacies, pharmaceutical manufacturers, and payers in the specialty pharmaceutical industry will convene in Orlando for two days to attend educational forums and facilitated workshops to identify collaborative initiatives that achieve: improved patient access to specialty therapies, increased patient education, and support demonstrable improvements in patient outcomes. Attendees at this invitation-only event are selected based on their executive and senior leadership roles in the industry. This unique forum provides leaders with the opportunity to engage collaboratively with industry peers to shape the evolution of this important segment of healthcare.
This is a great opportunity for manufacturers that utilize specialty pharmacies to discuss current and future trends in a workshop setting.
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