Few stakeholders in the industry would doubt the impact personalized care can have on patients’ health. We know that one-size-fits-all treatments and care plans are no longer the standard, especially for complex or chronic conditions such as multiple sclerosis, autoimmune disorders, and cancer. Different patients may respond differently to the same treatment regimen based on a multitude of factors, from pharmacogenomics to mental health to social determinants of health (including varying levels of family and community support, health literacy, income level, and more).
For example, one meta-analysis of 19 studies involving a total of 10,856 participants with health conditions including diabetes, mental health, heart failure, renal disease, asthma, and other conditions, found that “personalized care planning leads to improvements in certain indicators of physical and psychological health status and people’s capability to self‐manage their condition when compared to usual [non-personalized] care.”1 Another study, of more than 10,000 patients with Type 2 Diabetes, found that those who had a copy of their personalized care plan showed improved clinical outcomes and better adherence to medication than those who did not.2
But it’s not just patients who benefit from a personalized care approach – payors and providers can feel a positive impact from personalized care as well, in everything from reduced downstream healthcare costs to healthier member populations to reduced administrative burden. And specialty pharmacies can be a vital partner in supporting personalized care plans in ways that these stakeholders may not initially realize.
The Broader Impact of Personalized Care
Let’s break down some of the benefits of personalized care and how those benefits extend to all stakeholders in the industry.
Enhanced Patient Outcomes and Medication Adherence
As noted above, personalized care plans can significantly impact both clinical outcomes and medication adherence. For providers, it means that their patients with chronic and complex conditions are able to better manage their conditions and stay healthier for longer with fewer interventions, especially important in value-based care models.
Reduced Healthcare Costs
It follows naturally that improved clinical outcomes and adherence will lead to fewer downstream healthcare costs – a benefit for both patients and payors. Personalized care may lead to reduced healthcare costs for payors due to early detection and prevention of diseases and conditions, fewer acute care costs, targeted treatment options that are right for each patient, reduced hospitalizations, and improved patient engagement and adherence. For example, one study found that a personalized preventive medicine program delivering individualized care focused on lifestyle behavior modification, disease prevention, and compliance with quality-related metrics resulted in “significantly reduced utilization of ER services, inpatient admissions, and reduced health care expenditures.”3
Improved Provider Satisfaction and Efficiency
Personalized care plans can mean streamlined clinic workflow (for example, fewer prior authorizations and tests to order when a patient’s condition is well managed) and less burnout (with less double-booking and a lighter patient load when their patients’ health is better managed). One survey of primary care physicians found that those implementing personalized care for older adults with chronic conditions reported increased “satisfaction with patient and family communication and with chronic illness management” as well as increased satisfaction with their positions, compared to physicians not implementing this care model.4
Specialty Pharmacies’ Role in Personalized Care
Specialty pharmacies provide high-touch and often high-cost therapies for complex and chronic conditions. Their ability to integrate advanced clinical services, data analytics, patient education and support, and medication management and adherence makes them key partners for enabling and implementing personalized care plans in several ways, including:
Pharmacogenomic insights
Many specialty pharmacies are now equipped with, or partner closely with, pharmacogenomics labs, to interpret how a patient’s genetic profile affects medication response. This allows for more precise drug selection, dosing, and avoidance of adverse drug reactions. For payors, this can result in lower trial-and-error costs, reduced emergency care utilization, and reduced downstream costs.
Environment and social risk factor identification
With routine assessments and patient interactions, pharmacists and nurses at specialty pharmacies can uncover environmental barriers to adherence, such as housing insecurity, income limitations, or transportation challenges. Understanding these barriers and providing support helps ensure continuity of care – a win-win for payors and patients seeking to help patients manage their conditions and avoid future high-cost interventions.
Lifestyle-based customization
Specialty pharmacies support tailored, lifestyle-compatible treatment plans by helping patients manage side effects, improve diets, adhere to medication regimens, and navigate behavioral health challenges. This can help reduce provider burnout and administrative load while helping payors maintain healthy member populations.
Patient education and support:
Maximizing a personalized care plan requires numerous touchpoints and services throughout a patient’s journey. Specialty pharmacies’ medication adherence programs, health assessments, financial assistance, and other support helps payors ensure that their members feel they have the resources and relationships they need to manage their complex health conditions. This can lead to increased member satisfaction and retention.
Personalized Care Through Specialty Pharmacy Partnerships
Specialty pharmacies like California Specialty Pharmacy make personalized care plans possible by offering a complete care team – including pharmacists, patient care coordinators, and nurses – and partnering closely with not only the patient, but with payors and providers as well. We offer:
- Benefits verification, authorization support, financial assistance, and site-of-care determination
- Outreach to prescribers regarding drug interactions, dosage modifications, and alternative medication suggestions
- Education with each patient on potential side effects, drug interactions, proper storage requirements, and administration instructions
- Counseling with the patient’s family/caregiver on unique needs and medication administration requirements
- Nursing services in-home and in our ambulatory infusion centers (AICs), including lifestyle and socioeconomic barrier assessments, medication administration, education on self-administration, device training, and symptom monitoring
- Availability 24/7 for providers, nurses, patients, and caregivers
Personalized care plans for patients with complex and chronic diseases are critically important and can benefit all stakeholders in the healthcare ecosystem, which makes partnerships with specialty pharmacies essential. By opening lines of communication across all stakeholders and providing services and resources for patients, payors, and providers, specialty pharmacies help make the vision of personalized care a reality.
References:
- Coulter A, Entwistle VA, Eccles A, et al. “Personalised care planning for adults with chronic or long-term health conditions.” Cochrane Database Syst Rev. 2015 Mar 3;2015(3):CD010523.
- Mikkola I, Hagnäs M, Hartsenko J, et al. “A personalized care plan Is positively associated with better clinical outcomes in the care of patients with Type 2 Diabetes: a cross-sectional real-life study.” Can J Diabetes. 2020 Mar;44(2):133-138.
- Musich S, Wang S, Hawkins K, et al. “The impact of personalized preventive care on health care quality, utilization, and expenditures.” Popul Health Manag. 2016 Dec;19(6):389-397.
- Marsteller JA, Hsu YJ, Wen M, et al. “Effects of Guided Care on providers’ satisfaction with care: a three-year matched-pair cluster-randomized trial.” Popul Health Manag. 2013 Oct;16(5):317-25.
Legal Disclaimer: The content provided on this blog is for informational purposes only and is not intended to serve as medical advice, diagnosis, or treatment. While we make every effort to provide accurate and up-to-date information, the details shared here should not be considered a substitute for professional medical consultation or advice. By accessing this blog, you agree to hold harmless the author, publisher, and any associated parties from any claims, liabilities, or damages arising from the use or interpretation of this content.
©2025 California Specialty Pharmacy, LLC. All rights reserved.
