Help us welcome our newest HOSP Alliance Board of Directors Member and Chair of the HOSP Advocacy Committee, Dr. Onisis Stefas. At Northwell Health, Onisis develops the strategy and directs implementation of programs, policies, and procedures designed to integrate the health system’s pharmacy services. He also oversees the management, financial operations, and development of Northwell’s central pharmacy and for-profit subsidiary Vivo Health, which includes PBM, specialty, mail order, retail, and pharmacy consulting services.
Prior to joining Northwell Health in 2010, Onisis held numerous leadership positions at Fortune 500 companies, including CVS Caremark and the Target Corporation. After graduating from the Albany College of Pharmacy with a Doctor of Pharmacy in 2002, he received his MBA from Hofstra University. He holds adjunct faculty appointments at St. John’s University and Binghamton University and sits on the Advisory Board of the former. He is also a member of the American Society of Health-System Pharmacists, the New York State Council of Health-System Pharmacists, and the Long Island Society of Health-System Pharmacists.
Q: Tell us about your system’s specialty pharmacy. For example, how long have you have been operating, what is the size and/or the number of patients you serve?
A: Vivo Health Pharmacy is Northwell Health’s outpatient pharmacy network which provides integrated and specialized pharmacy services for patients, employees, and members of our community. Established in 2009, Vivo is now comprised of 10 pharmacy locations strategically placed throughout the health system, including retail, specialty, and mail order pharmacy services. In 2020, we serviced more than 72K unique patients, 559K prescriptions, and 162K deliveries. In addition, Vivo Health PBM covers more than 76K lives, saving our organization approximately $16M in year one.
Q: What made your system decide to establish its own specialty pharmacy?
A: We believe that nobody takes better care of their patients than the health system. An integrative and collaborative approach allows for more touchpoints throughout a patient’s care journey positively influencing patient outcomes.
What do you think HOSP will do that other organizations cannot or won’t do?
A: HOSP provides a collective voice advocating for the needs of our patients and providers and is focused on demonstrating the value an integrated health system-owned pharmacy brings to patient care. Other organizations support broader membership and may not fully appreciate or prioritize our unique needs.
What are some of the biggest challenges for this industry?
A: Access barriers to payer networks and limited distribution drugs impact health system specialty pharmacies from providing comprehensive pharmacy services to their patients. Limiting our ability to care for our patients is impacting the overall quality of care being provided. Additionally, ambiguity and a lack of transparency around DIR fees continue to present challenges for specialty pharmacies.
Can you share an example of a patient story that demonstrates the value of serving them through your system’s own specialty pharmacy (versus a large/mail order specialty pharmacy)?
A: One of our patients was scheduled to start therapy on time-sensitive medication. Unfortunately, a snowstorm in another part of the country delayed delivery from a national specialty pharmacy. Vivo was contacted by the prescriber and then coordinated with each of the stakeholders to fill the prescription and personally deliver the medication to the patient’s front door in a matter of hours. Our relationships with our providers, proximity to the patient, and the “can do” attitude of our staff make these wins possible.
How do you think health system owned specialty pharmacies help to address the problem with health inequity or disparity? Are there things the industry should be doing better?
A: An advantage of having a health-system-owned specialty pharmacy is the transparency of pertinent information. Our pharmacists have access to notes from providers, social workers, and case managers to gather information essential to targeting a patient’s individualized needs. We heavily invest in practice-based resources and centralized teams that provide patients with financial assistance and clinical support. Our Patient Management Program provides the same standard of care for ALL patients who fill specialty medications, regardless of location or socioeconomic status, thus improving access to enhanced services.
The industry, specifically pharma and payors, should consider the value that an integrated health system-owned specialty pharmacy brings and reduce barriers to access, so that all patients may receive enhanced specialty pharmacy services.