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From Access to Outcomes: The Changing Role of HUBs | NASP Specialty Pharmacy Podcast · Pharmacy Podcast Network

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  Speaker 1: You are listening to the global network of podcasters dedicated
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  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
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  Speaker 2: You're listening to the NASP Specialty Pharmacy Podcast, a collaboration
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  Speaker 2: between the National Association of Specialty Pharmacy and the Pharmacy
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  Speaker 2: Podcast Network. Each episode dives deep into trends, challenges, innovations,
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  Speaker 2: and patient-centric practices shaping the future of this dynamic and
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  Speaker 2: rapidly evolving industry. Whether you're a pharmacist or healthcare provider,
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  Speaker 2: patient advocate or industry leader, you're listening to the NASP
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  Speaker 2: Specialty Pharmacy Podcast. You'll hear expert insights, real-world evidence, and
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  Speaker 2: thought-provoking discussion that highlights all that makes specialty pharmacy special.
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  Speaker 3: In support of NASP's mission to empower specialty pharmacy stakeholders
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  Speaker 3: to advance the standard of patient care, NASP supports a
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  Speaker 3: free market healthcare system in which all specialty pharmacies compete
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  Speaker 3: on the same fair and level playing field. because that
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  Speaker 3: is in the best interest of the patients we collectively serve.
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  Speaker 3: NASP is committed to working with all stakeholders and policymakers
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  Speaker 3: to ensure that all patients have access to the life-saving
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  Speaker 3: medications they need and the high-touch patient care and support
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  Speaker 3: services they deserve from the pharmacy of their choosing.
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  Speaker 1: Hello, my name is Sheila Arquette, and I am the
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  Speaker 1: president and CEO of the National Association of Specialty Pharmacy.
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  Speaker 1: I am delighted to welcome my special guests from CenterWell Pharmacy,
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  Speaker 1: Narlan Lopes and Megan Weinbrenner to this episode of the
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  Speaker 1: NASP podcast. Narlan Lopes is Vice President of Pharmacy Hub
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  Speaker 1: Operations at CenterWell, where she leads strategic initiatives focused on
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  Speaker 1: optimizing hub services, enhancing patient access, and driving operational excellence
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  Speaker 1: across the specialty pharmacy ecosystem. With more than 20 years
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  Speaker 1: of experience spanning specialty pharmacy, life sciences, patient support services,
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  Speaker 1: and healthcare technology, she has built a career leading growth, innovation,
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  Speaker 1: and transformation in complex healthcare environments. Prior to joining CenterWell,
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  Speaker 1: Narlund held executive leadership roles at OptumInsight, where she oversaw
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  Speaker 1: portfolios spanning real-world evidence, clinical trial solutions, and analytics. She
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  Speaker 1: also held leadership positions at AssistRx and Walgreens Specialty Pharmacy,
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  Speaker 1: where she helped advance hub and specialty pharmacy solutions that
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  Speaker 1: improve patient access, engagement, and outcomes. Megan Weinbrenner, PharmD CSP,
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  Speaker 1: is a clinical pharmacy lead on the clinical strategy team
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  Speaker 1: at Centerwell Specialty Pharmacy. where she leads initiatives focused on specialty,
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  Speaker 1: pipeline forecasting, clinical strategy, and innovative programs designed to enhance
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  Speaker 1: patient outcomes. With more than a decade of specialty pharmacy experience,
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  Speaker 1: Megan brings expertise spanning clinical operations, rare disease management, specialty
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  Speaker 1: drug strategy, and patient-centered program development. Her work centers on
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  Speaker 1: aligning clinical innovation, operational excellence, and emerging therapies to improve
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  Speaker 1: care for patients with complex conditions and support the future
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  Speaker 1: of specialty pharmacy. Narlene and Megan, thanks so much for
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  Speaker 1: joining me today.
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  Speaker 4: Thanks for having us. Yes, thank you so much.
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  Speaker 1: So, Narlene, for listeners who may be less familiar with
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  Speaker 1: the concept, how would you define a patient services hub?
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  Speaker 1: And then what role does it play in helping patients
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  Speaker 1: access and stay on therapy?
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  Speaker 4: Well, Sheila, this will probably be my favorite question.
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  Speaker 5: It's my version of Hub 101. At its core, a
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  Speaker 5: patient services hub will run support programs, which are typically
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  Speaker 5: funded by the pharmaceutical manufacturer to help patients, providers, pharmacies,
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  Speaker 5: and insurers navigate the process of medication access, affordability, and adherence.
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  Speaker 5: They do this because, as we know, these are critical
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  Speaker 5: milestones in the patient journey for improving health outcomes. The
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  Speaker 5: three of us here know that understanding specialty pharmacy is
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  Speaker 5: knowing that our medications come with additional steps before a
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  Speaker 5: patient can start treatment. They may be insurance approvals, affordability programs,
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  Speaker 5: specialty pharmacy coordination, patient education, or the patients may need
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  Speaker 5: ongoing adherence support. The help helps manage those activities and
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  Speaker 5: reduce friction throughout that patient journey.
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  Speaker 4: I'll give an example.
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  Speaker 5: Let's say a patient is prescribed a specialty medication for
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  Speaker 5: severe asthma. The hub will help verify insurance coverage, identify
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  Speaker 5: whether prioritization is required, connect the patient with financial assistance programs,
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  Speaker 5: they'll coordinate with the specialty pharmacy, and provide ongoing support
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  Speaker 5: after therapy begins. Ultimately, their goal really is to support
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  Speaker 5: everyone in the care team for the benefit of that
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  Speaker 5: patient with a focus on prioritizing access and affordability for
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  Speaker 5: a complex process so patients can start therapy sooner, stay informed,
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  Speaker 5: and remain on that treatment longer.
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  Speaker 1: So hubs have been around for quite some time, but
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  Speaker 1: the healthcare landscape has changed significantly.
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  Speaker 4: And Arlene, how has the.
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  Speaker 1: Role of hub evolved over the years and what factors
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  Speaker 1: have driven it?
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  Speaker 4: That evolution? Yeah, great question.
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  Speaker 5: So if we go back several years, hubs are primarily
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  Speaker 5: focused on helping patients get through that access process. A
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  Speaker 5: lot of the work really just centered around benefits verification,
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  Speaker 5: prior authorization, finding that pharmacy, getting that.
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  Speaker 4: Fill as timely as possible.
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  Speaker 5: Interestingly enough, though, specialty medications have become more common, meaning
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  Speaker 5: the access and treatment process became much more complex. Patients
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  Speaker 5: weren't just looking for help getting access to therapy. They
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  Speaker 5: also needed education, affordability support, ongoing communication, and help navigating
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  Speaker 5: everything that happens after treatment.
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  Speaker 4: At the same time, providers.
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  Speaker 5: Were, and honestly still, are dealing with increasingly administrative burden.
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  Speaker 5: The manufacturers wanted greater visibility into what was happening after
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  Speaker 5: a prescription was written. They wanted to understand were patients
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  Speaker 5: getting stuck, why therapy starts were delayed, and what barriers
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  Speaker 5: were preventing patients from staying on treatment. As a result,
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  Speaker 5: the role of the hub expanded. What started as an
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  Speaker 5: administrative support function evolved into a broader patient support ecosystem.
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  Speaker 5: So today's hubs help coordinate access, affordability, education, adhering, and
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  Speaker 5: patient engagement. They also provide manufacturers with insights into the
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  Speaker 5: treatment experience. In many ways, hubs have evolved from simply
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  Speaker 5: helping patients start therapy to helping patients stay on therapy
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  Speaker 5: and helping providers and manufacturers better understand and improve that
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  Speaker 5: experience with data and insights.
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  Speaker 1: So despite all the progress that's been made, there are
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  Speaker 1: still significant barriers throughout the specialty medication journey. Megan, what
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  Speaker 1: are the biggest pain points for patients, providers, and manufacturers
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  Speaker 1: that today's hub models are trying to address?
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  Speaker 6: Yes, so even with all the advances we've seen in
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  Speaker 6: specialty pharmacy, there are still a lot of points along
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  Speaker 6: the journey where things can break down. First, from a
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  Speaker 6: patient perspective, one of the biggest challenges is navigating a
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  Speaker 6: complex process. Patients may be dealing with insurance challenges, They
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  Speaker 6: may be dealing with affordability concerns. They may be dealing
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  Speaker 6: with specialty pharmacy requirements and then uncertainty about what happens next.
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  Speaker 6: So for someone who's just received a diagnosis, you know,
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  Speaker 6: when you take all of that together, this can be overwhelming. Now, providers,
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  Speaker 6: they face a different challenge. They spend a tremendous amount
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  Speaker 6: of time on administrative tasks such as responding to payer requests,
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  Speaker 6: coordinating with pharmacies, and tracking down status updates.
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  Speaker 4: We all know these.
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  Speaker 6: Activities are important, right? But they can take away from
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  Speaker 6: patient care. Then you've got the manufacturers. And really, they're
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  Speaker 6: the ones who are ultimately investing in these support programs
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  Speaker 6: because they want to make sure and ensure that patients
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  Speaker 6: can successfully access therapy and achieve positive health outcomes through
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  Speaker 6: medication adherence. And really, one of the biggest challenges for
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  Speaker 6: all of us in the care space, along with our patients,
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  Speaker 6: is understanding where patients are getting stuck in the process.
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  Speaker 6: For instance, is it an insurance issue? Maybe it's an
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  Speaker 6: affordability issue. Did the patient abandon the prescription? Did the
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  Speaker 6: provider run into administrative barriers? Historically, it hasn't always been
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  Speaker 6: easy to see where those breakdowns occur. Another challenge, I think,
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  Speaker 6: is that multiple stakeholders are often involved in supporting the
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  Speaker 6: patient journey. So imagine that a patient receives approval for therapy,
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  Speaker 6: but they're contacted separately by, let's say, the provider's office,
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  Speaker 6: the hub, the specialty pharmacy. and an affordability program. Everyone
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  Speaker 6: here is trying to help, but the experience can become
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  Speaker 6: confusing rather quickly. Patients may not know who to call
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  Speaker 6: with questions, and providers can spend their valuable time responding
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  Speaker 6: to multiple requests different parties. So what today's hub models
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  Speaker 6: are really trying to do is to bring all of
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  Speaker 6: those pieces together. The goal isn't necessarily for the hub
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  Speaker 6: itself to do everything. It's to really better orchestrate the
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  Speaker 6: cure experience, right? So reduce the duplication, improve the coordination
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  Speaker 6: across all stakeholders, reduce friction for patients, lessen that administrative
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  Speaker 6: burden for providers, and provide manufacturers with greater visibility into
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  Speaker 6: where barriers exist. At the end of the day, you know,
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  Speaker 6: everyone has the same goal for the patient, and that's
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  Speaker 6: helping the right patient get on the right therapy and
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  Speaker 6: stay on it. So hubs are designed to help make
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  Speaker 6: that process simpler. more connected and more effective for everyone involved.
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  Speaker 1: So we're hearing more about automation, digital engagement, personalized support,
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  Speaker 1: and data-driven decision-making. Narlene, what is driving those changes and
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  Speaker 1: how are they reshaping expectations for what a hub should deliver?
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  Speaker 5: Yeah, there is so much out there with automation and
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  Speaker 5: digital and all of this. So I definitely think there's
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  Speaker 5: several industry trends that are converging at the same time.
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  Speaker 5: First and foremost, patient expectations are changing. Consumers like us
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  Speaker 5: are accustomed to personalized digital experience in nearly every aspect
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  Speaker 5: of our lives. And they increasingly expect healthcare to offer
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  Speaker 5: the same convenience and transparency and honestly ease of access.
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  Speaker 5: For example, as we know, all of us can check
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  Speaker 5: the status of the package, schedule an appointment with just
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  Speaker 5: a few clicks. And patients are now increasingly expecting that,
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  Speaker 5: that same level of transparency, that same level of convenience
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  Speaker 5: when trying to access and manage medications. But it's also
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  Speaker 5: now happening with complex medications. At the same time, As
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  Speaker 5: I highlighted earlier, provider offices are facing growing administrative demands
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  Speaker 5: and they're looking for ways to simplify processes and reduce
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  Speaker 5: that manual work.
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  Speaker 4: The manufacturers, as we.
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  Speaker 5: Mentioned, are also seeking deeper insights into that patient journey.
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  Speaker 5: They really want to understand access barriers. They want to
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  Speaker 5: know program performance and they want to really understand where
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  Speaker 5: the patients are struggling. Technology is helping address many of
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  Speaker 5: those challenges. A task that once required multiple phone calls
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  Speaker 5: and faxes, and yes, I said faxes, can increasingly be
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  Speaker 5: completed through integrated digital workflows. Advances in automation, artificial intelligence,
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  Speaker 5: and data integration make it possible to streamline routine activities,
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  Speaker 5: improve visibility across that treatment journey, and identify issues earlier
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  Speaker 5: than ever before. We're also seeing a shift from one-size-fits-all
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  Speaker 5: support models to that personalized engagement. Some patients do prefer
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  Speaker 5: speaking with a care team member.
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  Speaker 4: Others are going.
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  Speaker 5: To prefer a text message or going to a mobile app,
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  Speaker 5: logging on to a portal or digital reminders. The ability
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  Speaker 5: to offer support through multiple channels helps create a more
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  Speaker 5: flexible and patient-centered experience. Let's also not forget that manufacturer
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  Speaker 5: expectations are increasingly focused on patient outcomes. As a result,
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  Speaker 5: hubs must evaluate operating models that support outcomes-driven activities and
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  Speaker 5: processes rather than purely transactional services. This shift could significantly
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  Speaker 5: impact technology strategies, how we look at workforce, hiring models,
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  Speaker 5: or even pricing frameworks across hub organizations. Understanding and adapting
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  Speaker 5: to this market evolution is critical. That'll help align with
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  Speaker 5: manufacturer needs and building an execution model that prioritizes patient
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  Speaker 5: outcomes throughout the patient journey, rather than focusing solely on
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  Speaker 5: transactional touchpoints. Ultimately, expectations for hubs are expanding, as everything
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  Speaker 5: I highlighted there. Solutions should not only support access, but
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  Speaker 5: also create a more personalized, transparent, outcomes-driven, and efficient experience
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  Speaker 5: throughout that entire treatment journey.
• 15:00
  Speaker 1: So let's questions for both of you. As hub models
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  Speaker 1: continue to evolve, why is it important for organizations like
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  Speaker 1: CenterWell to understand the space And how does that knowledge
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  Speaker 1: support broader pharmacy and patient care goals?
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  Speaker 2: Sure.
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  Speaker 4: I'll start, Megan.
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  Speaker 5: So I think one of the reasons this is so
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  Speaker 5: important for CenterWell is that we have a front row
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  Speaker 5: seat to the specialty medication process. As a specialty pharmacy organization,
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  Speaker 5: we work closely with our providers, manufacturers, insurers, and our
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  Speaker 5: patients every day. That gives us firsthand visibility into where
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  Speaker 5: processes work well and where opportunities still exist to really
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  Speaker 5: improve the experience. For us, understanding the evolution of these
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  Speaker 5: health models isn't just about following industry trends. It's really
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  Speaker 5: about understanding how the healthcare ecosystem is changing and how
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  Speaker 5: stakeholders like us can work together more effectively to support
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  Speaker 5: our patients. We also recognize that specialty therapies continue to
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  Speaker 5: become more complex.
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  Speaker 4: As new treatments.
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  Speaker 5: Enter the market, the need for coordination, communication, and patient
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  Speaker 5: support is only going to increase. For us, staying informed
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  Speaker 5: about evolving health capabilities helps us anticipate future needs and
• 16:25
  Speaker 5: identify opportunities to better support patients and providers. But more importantly,
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  Speaker 5: it really allows us to bring a specialty pharmacy perspective
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  Speaker 5: to really important conversations about innovation and patient access. Megan,
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  Speaker 5: anything else that you would like to add?
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  Speaker 7: Yeah, I think you touched on this really well.
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  Speaker 6: And I just add that from a specialty pharmacy perspective,
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  Speaker 6: understanding these evolving hub models helps us to better prepare
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  Speaker 6: for the future of patient care. You know, many of
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  Speaker 6: the therapies that we support today are highly specialized. They
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  Speaker 6: require extensive access support and often involve multiple stakeholders throughout
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  Speaker 6: the entire treatment journey. And so the more we understand
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  Speaker 6: how the HUB programs are evolving, the better positioned we
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  Speaker 6: are to support patients as they begin developing and then
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  Speaker 6: also continue on therapy.
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  Speaker 7: It also helps us to identify.
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  Speaker 6: Opportunities to really align patient support services with the clinical
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  Speaker 6: and operational resources that are already within the specialty pharmacy.
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  Speaker 7: So rather than creating.
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  Speaker 6: Additional complexity, we really want to understand how different stakeholders
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  Speaker 6: can work together more effectively and efficiently. And as new
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  Speaker 6: therapies continue to emerge, having that visibility into evolving access
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  Speaker 6: models allows us to proactively prepare clinical programs, patient education resources,
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  Speaker 6: and also support strategies that can help patients navigate treatment
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  Speaker 6: more successfully.
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  Speaker 1: This question is also for both of you. If these
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  Speaker 1: next-generation hub models are successful, what does that mean in
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  Speaker 1: practical terms for patients, providers, manufacturers, and clinical outcomes?
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  Speaker 6: Sure, I can start with this one, Marlon. So if
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  Speaker 6: these next-generation hub models are successful, the impact should be
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  Speaker 6: both meaningful and measurable. For patients, success means fewer delays
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  Speaker 6: in starting therapy and It means clear communication throughout the
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  Speaker 6: entire process. And really, it means support that is tailored
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  Speaker 6: to their individual needs. The healthcare system often feels complicated,
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  Speaker 6: and successful hub models can help make that experience.
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  Speaker 7: Simpler and also easier to navigate.
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  Speaker 6: So success might mean reducing a patient's time to therapy
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  Speaker 6: from weeks to days. allowing them to start treatment sooner
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  Speaker 6: and then potentially improving clinical outcomes. It could also mean
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  Speaker 6: giving patients greater visibility into what's happening along the way,
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  Speaker 6: including clear information about costs, including next step, and also
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  Speaker 6: including the status.
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  Speaker 4: Of their therapy.
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  Speaker 7: So the more informed and supported patients feel.
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  Speaker 6: The easier it becomes for them to stay engaged in
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  Speaker 6: their own care. And for providers, success means reducing that
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  Speaker 6: administrative burden that we've mentioned before and improving visibility into
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  Speaker 6: the status of their patients. When providers spend less time
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  Speaker 6: managing logistics, they can spend more time focused on that
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  Speaker 6: patient care and clinical decision-making. Now, from a clinical standpoint,
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  Speaker 6: Earlier treatment initiation and stronger adherence support can create opportunities
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  Speaker 6: for improved therapy persistence, better disease management, and ultimately better
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  Speaker 6: patient outcomes.
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  Speaker 7: Marilyn, what were your thoughts on this question?
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  Speaker 4: I think, I mean, you've covered those so well.
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  Speaker 5: You know, from a manufacturer perspective, I think success means
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  Speaker 5: gaining just a clear understanding of what is happening across
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  Speaker 5: that therapy lifecycle. That to me includes visibility into where
• 20:43
  Speaker 5: patients may encounter barriers, how quickly they're starting therapy. how
• 20:48
  Speaker 5: effectively support programs are performing, and where improvements can be made.
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  Speaker 5: Those insights will really help them make more informed decisions
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  Speaker 5: and better support the patients who are relying on their therapies. Operationally,
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  Speaker 5: I really think success means creating processes that are efficient,
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  Speaker 5: they're scalable, and they're easier for all stakeholders to navigate.
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  Speaker 5: information moves seamlessly, administrative tasks are reduced, and organizations can
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  Speaker 5: focus resources where they can have the greatest impact. I
• 21:23
  Speaker 5: think when done well, the result is faster therapy initiation,
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  Speaker 5: stronger patient engagement, like we've discussed, improved adherence, and just
• 21:34
  Speaker 5: those outcomes, right?
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  Speaker 4: Better outcomes for our patients.
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  Speaker 5: That's really the promise of the Next Generation Hub model.
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  Speaker 5: creating a more coordinated and effective experience for everyone involved
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  Speaker 5: while keeping the patient at the center of the journey.
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  Speaker 1: So, Narlene, looking ahead three to five years, what do
• 21:53
  Speaker 1: you think will differentiate the most successful hub models?
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  Speaker 5: This is another great question, right? To bring it all together,
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  Speaker 5: I really think looking three to five years ahead, The
• 22:04
  Speaker 5: most successful hub models will be the ones that evolve, right?
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  Speaker 5: They're evolving from providing services to becoming true orchestrators of
• 22:14
  Speaker 5: the patient journey. Traditional hub models have done a really
• 22:19
  Speaker 5: important job supporting foundational services like benefit verification, prior authorization,
• 22:26
  Speaker 5: and patient onboarding.
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  Speaker 4: Those functions aren't going away.
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  Speaker 5: In fact, they're still super critical, but they'll increasingly become
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  Speaker 5: the baseline expectation.
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  Speaker 4: They're no longer a differentiator.
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  Speaker 5: What will set leading health models apart will be their
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  Speaker 5: ability to connect stakeholders across the healthcare ecosystem and create
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  Speaker 5: a more seamless experience for patients. That includes leveraging data
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  Speaker 5: and technology to provide greater transparency, identifying barriers earlier in
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  Speaker 5: the process, and enabling more proactive interventions throughout the patient experience.
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  Speaker 4: We'll also see a greater emphasis on integration.
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  Speaker 5: The hubs that can effectively connect manufacturers, providers, specialty pharmacy payers,
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  Speaker 5: and care teams will be best positioned to improve efficiency
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  Speaker 5: and reduce the complexity that often exists in specialty medication access.
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  Speaker 5: And we know that is not an easy thing. That
• 23:30
  Speaker 5: is the complex thing to tackle, right? Ultimately, I think
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  Speaker 5: success will be measured by more than operational metrics. The
• 23:39
  Speaker 5: leading hub models will be the ones that can demonstrate
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  Speaker 5: real value through faster access to therapy, improved patient engagement,
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  Speaker 5: stronger adherence, and better clinical outcomes. Those organizations will combine
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  Speaker 5: operational excellence with a patient-centered approach, creating benefits not only
• 23:56
  Speaker 5: for those manufacturers and providers, but most importantly, for the.
• 23:59
  Speaker 4: Patients we all serve.
• 24:00
  Speaker 1: Thank you so much, Narlan and Megan, for chatting with
• 24:03
  Speaker 1: me and sharing this valuable information.
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  Speaker 4: Thank you. Thank you.
• 24:07
  Speaker 1: And as a reminder, NASP corporate members are invited to
• 24:11
  Speaker 1: be my guest on one complimentary podcast per year. For
• 24:14
  Speaker 1: more information about this or other NASP membership benefits and events,
• 24:18
  Speaker 1: please feel free to reach out to membership at naspnet.org
• 24:24
  Speaker 1: or visit our website at www.naspnet.org. Until next time, have
• 24:31
  Speaker 1: a great day.