← Becker’s Healthcare Podcast
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- [00:00]
A
Hi everyone. This is Grace Lukeller with Becker's Healthcare. Thank you so much for tuning into the Becker's Healthcare podcast series. Joining me for today's discussion is Ryan Talford, who serves as the Vice president of Portfolio Strategy at Accelerate Pharmacy Solutions. Ryan, thank you so much for being here today. I'd love to have you start off by introducing yourself and telling us a little bit more about your role at Syncora, giving us a quick overview of The Pharmacy Outlook 2026 report and what you set out to learn from health system pharmacy leadership.
- [00:31]
B
Yeah, happy to be here and happy to talk a little bit about the pharmacy outlook. And I think as folks are familiar with us as Ancora, as a wholesale distributor and the services that we provide in that space, shipping over 5 million doses of medications to providers large and small across the country, we also do a heck of a lot more than pick, pack and shift. And so part of that, when we focus on how are we supporting our pharmacy leaders is getting good, deep insight as to what's important to them, what's important to our chief pharmacy officers and our pharmacy leaders across the health system space. And so what we said set out to do in that Pharmacy Outlook report is really to validate some of the assumptions that we had around what was important to our pharmacy leaders and also get some insights that could be benchmarks for these leaders as they as they chart their course going forward. So it was a great response from that report. We've got. We got over 100 respondents across health systems large and small, some of our most strategic health systems there that have been leading the country in a lot of different ways, but also those that are early in their journey. So really good insights as to where are those areas of the pharmacy enterprise that are highest priority for folks, what are some of those indicators of success and where are folks still focusing?
- [01:43]
A
Wonderful. Well, thank you so much for sharing. And I'd love to know, for a CPO who wants to move from benchmarking to an actionable plan, which two or three enterprise level metrics do you think are most worth tracking and what decisions should those metrics be driving?
- [01:58]
B
Yeah, I think that's a really good question. And I think when we think about metrics, especially in the pharmacy space and in health systems overall, for me it boils down to two different areas we should be thinking about. What are those metrics that are going to help us determine whether or not we're being successful at driving patient outcomes? And two, what's keeping the lights on for us? And so we all have to drive sustainability in the areas of responsibility that we have. So we should be thinking about those things. What we saw in the outlook report was that a lot of the core areas that are driving that sustainability for health systems continue to be high focus. We see a high focus on specialty pharmacy. We see a high focus on infusion book of business. We see a high focus on, on patient access and affordability. We see a high focus on industry trends and shifting sands within the regulatory and payer space. And so when we look at those benchmarks, that would indicate to us, are we, are we doing well by our patients and are we doing well by our organizations? We can look at things like our capture rates or our rates of internalization. How well are we maintaining that integrated care for those patients in areas like specialty pharmacy and like infusion? Depending on, we'll talk, you know, maybe have an opportunity to talk a little bit more about what some of those benchmarks are. But I think depending on how we're performing in those spaces, that could give us some clues to where we want to try to dig in and solve some of the problems that would be resulting in deltas and those metrics. And so we also look at things like time to treat for our infusion and also for our specialty pharmacy patients. So when we see the delays in those care, that obviously is delays in those patients getting outcomes, it's also patient experience, it's provider experience that start to slip there. So good opportunities to create some actionable steps for health system leaders to be able to close those gaps. And then we also take a look at what's happening in that payer space. So what trends are there around what's driving some of our patients out of our system. And so looking at that leakage could help us. When we think about what actions do we take there, it starts to inform a strategic direction on what do we need to build as far as infrastructure. What do we need to build as far as people, processes and technologies that would support our ability to take care of those patients internally more effectively?
- [04:06]
A
So the report finds that only about 54% of specialty patients are managed internally on average. What are the most realistic steps CPOs can take to reduce that leakage without compromising patient choice or overloading frontline teams?
- [04:22]
B
Yeah, I think that was an interesting number. I don't know that many CPOs listening will find it super surprising. I think it's interesting to look at when we think about where we are in the arc of maturity for specialty pharmacy. For a lot of health systems, this is becoming A very mature service line. And so the problems that we faced as we were standing these things up are different than what we're facing at that level of maturity. But what we would see as part of that, what causes that leakage or that disconnection from those patients being able to have their care maintained inside the health system. Most folks will readily identify those payer issues, those narrow networks on the payer side of the house, limited distribution drugs as large contributors in the. Absolutely are. In addition to that, clearly there's structural and functional approaches to our specialty pharmacy and our infusion books of business that can really help us maximize the therapies that we do have access to. And so I think for health systems, what steps can they take? I think there's some real tactical areas to focus. So I think it's first make sure that the basics are handled. I think we hear a lot even at the conference today around what health systems can do to make sure that their processes around patient access and affordability, having that be predictable for their providers and for their patients, having that be a consistent pinch point that flows through pharmacy, to have all of that complexity addressed for those patients so that that leakage is minimized to really what we can't fill. And then as you get towards the high end of the complexity, that's where we start to see some innovation with health systems really being thoughtful about engaging their managed care partners, their legal and compliance partners, their industry relations folks, and having a real thoughtful strategy, interaction with payers around interaction with manufacturers and trying to identify where there's win wins to start to erode some of that, those barriers that exist to be able to have access to care for those patients.
- [06:18]
A
Only 4% of respondents say they're fully ready for cell and gene therapies. What does readiness look like for a health system pharmacy leader? And where should CPOs focus in the next 12 months to close that gap?
- [06:30]
B
Yeah, that's a, that's a good call out. And that was kind of a startling statistic. I think. You know, we in the pharmacy space have been watching cell and gene for the last, you know, honestly, going on decades now. We think about the promise of personalized medicine and genetically tailored therapies that could be durable and borderline curative in a lot of these, in these disease states has been something that holds a lot of promise. I think what we're seeing now is that the commercialization and the delivery for these, for these therapies is starting to, starting to land. We're starting to see manufacturers be able to bring to market therapies that are viable as commercial options. And so CAR T's obviously been out and in play for a number of years now. We see a lot of organizations in the oncology space that have really well developed muscles in the CAR T space. We see pediatric facilities that are blazing trail in really holistically being able to care for our most vulnerable patients with gene therapies that are totally cutting edge. I think what's driving the push right now for health system leaders to think about cel and gene differently than they have before outside of the pediatric facilities, outside of the academic medical centers, outside of the cancer centers, is when we look at the pipeline and what's coming, there's a lot of non rare indications that we see staring us down not in the next 10 years, but within the next year to two years. And so obviously, when you think about how do we care for a patient population that is, that is exponentially larger than we've seen historically with these cell and gene therapies, that takes a different approach. We can't, if we think about inflammatory indications for CAR T therapies, you know that that patient population isn't going to be able to throw flow through your cancer center. And so that means health systems are going to have to start to reconcile how do we want to approach this? How do we want to think about creating a vertical in this space? How do we want to create, do we want to create teams that are specific to cell and gene? Which of these therapeutic areas that are coming down the pipeline as we see drug development start to accelerate, which of these therapeutic areas do we want to play in? How do we size and effectively project out the market? There's a lot of questions in that space and there's a lot at stake. These are obviously extremely high cost therapies with a lot of complexity to it, but they're truly transformational in the spectrum of care. And so when we think about what's at stake there, health systems can have the ability to really define the market and what cell and gene therapies look like for their communities. And the ability to do that in a way that creates additional sustainability financially for the, for the health system exists. But also if we, if we get that wrong, there's a lot of risk. And so I think that's what's starting to keep people up at night is to say it's not going to be some, you know, it's not going to be isolated to the areas that has been. It's going to be something that we can't ignore as as health systems and the template is still being developed. And I think where the other piece where where pharmacy is starting to play into this is similar to some of the other areas that this is a multidisciplinary problem and pharmacy continues to be the thread that pulls through it. So I think we see more of our innovative health systems really start to lean into our cutting edge pharmacy leaders to take the lead in that space. And so while we're early days there, it's really also kind of an exciting time for pharmacy to lead out in this wonderful.
- [09:53]
A
Well, Ryan, thank you so much for sharing these thoughts. And as we wrap up, I would love to know what are the two or three things you'd want every CPO listening walk away from this report and from our conversation today with yeah, I
- [10:07]
B
think a few things. I think we should be encouraged as a pharmacy profession and where we sit within the health system ecosystem overall as what we've accomplished, what we've been able to build and how we've we've driven sustainability for health systems overall. And when we look at the growth of specialty pharmacy, we look at some of the innovative things that's happening within infusion. When we think about how folks are getting involved in value based care, I think it's a testament to to the industry that pharmacy has a really role to play in a lot of these areas that are very high value to patients and to health systems, but are very multidisciplinary. And I think the core takeaway from a lot of this is as folks take a look at the data that's in there, the benchmarks that are there, measure that against where they sit today and think about how do I craft that future. The chief pharmacy officers and pharmacy leaders in the health system space are really well positioned to lead out in this. And so thinking about all of those areas that have a lot of the the same common threads, medication as its backbone, a high degree of complexity, a high degree of need to be able to coordinate across stakeholders. I think pharmacy leaders have developed some really strong muscles in this space and I think have a proven track record at this point to be able to lead out. So I would say to those that are thinking about any of these areas and are on the fence about hey, is this my area, is this my area to lead or is it not? I would say emphatically it is. You know, pharmacy is well positioned to be able to lead out for health systems in areas like infusion, like patient access and affordability, like cell and gene, that are multidisciplinary but are high value. And so I, you know, I, as a pharmacist, I've never been more encouraged about what pharmacy can do for, for our patients and for our health systems in the face of the complexity that's facing us today.
- [11:51]
A
Fantastic. Thank you, Ryan, for your time and insights today. And we also want to thank our podcast sponsor, Accele Pharmacy Solutions. You can tune in to more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.