A Pioneer in Specialty Pharmacy, UIC Keeps Leading
UIC’s Specialty Pharmacy carries on Stubbings’s national leadership
When Professor JoAnn Stubbings retired this year, she left behind a UIC Specialty Pharmacy Services (SPS) program that had bloomed in size and importance. Stubbings retired March 1 after serving as associate director of SPS, among many other roles. Dr. Matt Rim, from the University of Utah, succeeded her in May.
SPS started at UIC in 2007 “with one patient, one prescription, and one parttime pharmacist,” a UIC report said. Today, the department boasts 23 team members, national leadership and prominence, and a pioneering integrated-healthcare model. Housed in one of the seven ambulatory care pharmacies operated by the UIC College of Pharmacy, SPS has been very successful, said Dr. Glen Schumock, dean of the college.
“As a group, [the ambulatory care pharmacies] provide an important service to a largely underserved population,” he said. “Specialty pharmacy has been key to the overall growth of these efforts and performs well financially— supporting other functions.”
Dr. Sandra Durley, senior associate director of Ambulatory Pharmacy Services, attributed much of SPS’s success to the stewardship of Stubbings and her leadership team. “I think a lot of it has to do with the focused leadership identifying that SPS is an opportunity for our department to grow,” Durley said.
A DRIVING FORCE
In particular, Durley credited Stubbings with pushing SPS’s success. “JoAnn has been a driving force behind our specialty pharmacy services,” Durley said. “JoAnn took the leadership role in developing workflow processes and business plans and recruiting and developing the staff . . . to make sure that we were able to provide the best possible services.”
Schumock agreed. “JoAnn Stubbings has been a trailblazer in the specialty pharmacy arena—especially in the health-system environment,” he said. “She is a national expert and leader and has brought very positive attention to UIC and what we do here.”
That national recognition reached new heights two years ago, when Stubbings became executive committee chair of the newly created Section of Specialty Pharmacy Practitioners at the American Society of Health-System Pharmacists (ASHP), one of the nation’s largest pharmacy professional organizations.
A GROWING FIELD
Specialty pharmacy, at its core, consists of the pharmaceutical care of patients with complex, chronic, and rare conditions, often involving high-cost medications. UIC’s SPS program treats patients who have cancer, immune disorders, and more, and has grown to include a call center, a mail-order department for prescription fulfillment, a patient-access center, and an oral-oncology center.
Over the last decade, Durley said, use of specialty pharmacy medications has escalated and account for a significant share of overall drug spending. A 2018 IQVIA study found that specialty medications constituted just 2.2% of dispensed prescriptions but nearly 40% of spending, projected to grow to 50% by 2020, Pharmacy Times reported. “And it’s projected that by 2023, it will be even more,” Durley said.
Seeing such potential in the area, Durley, Stubbings, and others at UIC wanted to bring specialty services to the college early on. They traveled to Minnesota in 2007 to learn from some of the leaders at the time—the Mayo Clinic and Fairview Pharmacy.
Since then, UIC’s SPS program has grown to be a leader in its own right, pioneering an integrated model of specialty pharmacy. This system links SPS to provider clinics via clinical pharmacists embedded in those centers. The setup gives SPS unique access to patients, providers, and electronic health records, streamlining the process of getting specialty medications approved, paid for, and in patients’ hands.
“Our pharmacy staff works with physician providers as well as the clinical pharmacy pharmacists . . . to increase the capture of the number of specialty pharmacy prescriptions that were filled in our pharmacies,” Durley said.
SPS staff members then take on various insurance issues, working to process prior approvals, get doctors the information they need, and ensure that patients are eligible to receive treatment. UIC also leverages its integrated model to help overcome insurance companies’ frequent preference for outside specialty pharmacies, Durley said. Embedded clinical pharmacists work with SPS staff to capture as many specialty pharmacy prescriptions as possible, so UIC can offer patients better service by providing in-house, integrated knowledge.
“As an academic medical center, we have access to the patient’s electronic health record. We have direct access to the patient and the provider,” Durley said. “So, we’re very well suited to provide a higher level of care.”
ALWAYS A PIONEER
UIC’s program brings a number of other advantages. To better compete with larger specialty pharmacies that are aligned with insurance providers, SPS proactively sought two significant accreditations: from the Utilization Review Accreditation Commission (URAC), starting in 2015, and the Accreditation Commission for Health Care (ACHC), starting in 2016, with recent reaccreditation from both organizations. SPS was one of the first health-system specialty pharmacies in the country to earn such dual accreditation.
“We proactively sought accreditation and made sure that we were . . . qualified and able to provide those services . . . [securing] the same accreditation that the larger specialty services pharmacies have,” Durley said.
UIC’s SPS program also enables UI Health’s participation as a covered entity in the 340B Drug Pricing Program, with the UIC pharmacies serving as contract pharmacies for the hospital. A portion of the 340B savings is used to support clinical pharmacy services in many outpatient clinics at UI Health, Durley said. “Pharmacists in these areas provide services that increase medication adherence and result in improved clinical outcomes for our patients,” she said.
In addition to pioneering an integrated specialty pharmacy system, SPS created a unique workflow-management software application to pair with it, developed by former SPS student and information systems pharmacist Dr. Sherif Abdou.
Under Stubbings’s leadership, SPS also excelled in specialty pharmacy publication and research, Durley said, with “over 100 publications and presentations at national pharmacy and specialty pharmacy journals and meetings.” That includes a study last year in the ASHP’s journal on prescription drug spending, on which Schumock, Stubbings, and her successor, Rim, collaborated.
SPS’s commitment to communication extends to student education, as well. The department hires pharmacy students, hosts academic and experiential rotations, and provides independent study and research opportunities.
That makes a big difference both for pharmacy students and the future of the field as a whole, Schumock said, again crediting Stubbings. “Her development of students and mentorship of new or junior faculty and pharmacists has created a pipeline of well-trained folks to follow in her footsteps—whether at UIC or across the country,” he said. “Her influence and legacy are immeasurable.”
SPS at UIC has an expansive future. Not only has Stubbings’s successor, Rim, collaborated on research with UIC, but he’s also stepping into her national leadership position at ASHP. Rim, who served as manager of the pharmacy ambulatory clinical care center at the University of Utah, shared his expertise with UIC last year, at Stubbings’s invitation.
“The people working at UIC, I was always impressed. . . . They really care about their patients,” Rim said. “That’s what made me decide to move to Chicago.”
And Rim will lead UIC’s SPS program into a promising future for the field as a whole, Schumock said.
“These drugs . . . represent the fastest-growing medication category,” he said. “The fact that we have an established and highly successful specialty pharmacy positions us well to take advantage of these market trends.”