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Do You Need More than One Accreditation to Compete in Specialty Pharmacy?

Written by: Kimberly Commito on Monday, March 27, 2017 Posted in: Specialty Pharmacy

With the numbers of both specialty medicines and specialty pharmacies on the rise, payers and specialty drug manufacturers have to find ways to distinguish the top-performing pharmacies from those that don’t hit the mark. Increasingly, accreditation is the method of choice for doing so. Therefore, achieving accreditation can give specialty pharmacies a competitive advantage, proving to payers, pharmacy benefit managers, and drug manufacturers that your organization has what it takes to ensure that patients get their medications on time and that their progress and outcomes are monitored and reported.

Satisfy accreditation requirements with CareTend!

Of course, as more specialty pharmacies achieve accreditation, the competitive gap is narrowed, prompting some to ask if additional accreditations may be required to ensure access to limited-distribution contracts and networks. Those who have gone through the accreditation process know that it’s a sizable investment of both money and time to ensure that all processes are documented, compliance standards met, and that staff are trained to deliver on the care that is promised by your organization. Is the extra cost worth it? Many pharmacies believe so.

Data gathered by Drug Channels Institute indicates that, among the 378 specialty pharmacies accredited by the current leaders in pharmacy accreditation—Accreditation Commission for Health Care (ACHC) and URAC—24% are already accredited by both. Because, reportedly, some PBMs are now requiring multiple accreditations, I expect this percentage to increase in the next few years. If it’s something you’re considering, then it’s probably wise to begin the process given that the time to accreditation can be several months to a year or longer (although once you’re accredited, the second should go a little more smoothly).

Here are some additional accreditation questions that we commonly receive.

  • Are all accreditations the same? The two most common organizations are ACHC and URAC. Their requirements differ, so do your research to determine which organization is the best fit for you. Costs also vary between the two organizations as does the time it takes to complete accreditation, which can range from 90 days to up to a year.
  • What standards will the accreditation organization use to evaluate my business? Some of the common policies and procedures that are evaluated are related to provision of care, quality outcomes, performance improvement, patient rights and responsibilities, patient records, patient and employee safety, infection control, fiscal operations, and HR management.
  • Once I obtain accreditation, how long does the certification last? Accreditations are good for three years, but it is an ongoing responsibility to make sure you are compliant with your accrediting body’s standards. About 2½ years after your last accreditation, you should contact your accrediting body and being preparing for the next survey.
  • If I am a start-up pharmacy with a limited budget for accreditation, what are my options? You could seek advice from a consultant to help you evaluate your overall level of preparedness for the evaluation process, or you can visit each accrediting organization’s website to review the standards and assess your business yourself. You could also compare pricing and start with the most affordable option. Unfortunately, with the competitive nature of the business and the expectation for accreditation, your market share potential will be limited without it, so while you think you can’t afford it, the price for not getting accredited may be even higher.


Mediware is committed to helping your pharmacy stay compliant with accreditation requirements. Our latest software solution, CareTend, is designed specifically for the specialty pharmacy industry and can help your pharmacy meet payer, manufacturer, and accreditation organization requirements.


Source: Drug Channels;

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