New Case Study: Children’s National Hospital Builds an On-Site Specialty Pharmacy to Improve Financial Strain, Labor Shortages and Access to Affordable Medications
Drug manufacturers have imposed stringent cuts to restrict safety-net hospitals (covered entities) like Children’s National Hospital, located in Washington D.C., from accessing the 340B Drug Pricing Program for medications dispensed by a contract pharmacy. The health system relied heavily on a large chain retail pharmacy in their lobby, which utilized more than 50 additional contracted pharmacies to serve the hospital’s community. The restrictions had a negative financial impact on the health system, decreasing their ability to provide affordable and comprehensive healthcare services for their vulnerable pediatric populations.
A Partnership Designed to Improve Access to Affordable Medications
Children’s National Hospital partnered with Clearway Health to evaluate, strategize, plan and implement a variety of creative specialty pharmacy solutions. Together, they sought ways to reduce the health system’s reliance on contract pharmacies by capturing the attainable opportunity for prescriptions written by their providers. This strategy allowed the hospital to better serve disadvantaged populations and focus more time on patients.
“An advantage to partnering with Clearway Health was that they were rooted in a real health system that had been active for years, and one that owned a large health plan, so they were used to accountability, including for low-income Medicaid patients across an entire state. Their ability to understand our circumstances, and tailor an approach to our specific needs is what stood them apart,” said Eric Balmir, M.S., PharmD, CIM vice president of clinical ancillary and chief pharmacy officer at Children’s National Hospital.
Clearway Health embedded pharmacy liaisons directly into the health system’s ambulatory clinical teams to improve medication access, patient compliance, adherence, patient experience and implement programs to better screen patients for diseases. This new service line helped to decrease provider and staff burden and improve clinical outcomes – all while decreasing costs and reliance on contract pharmacy arrangements.
Procuring Access to Novel Cell and Gene Therapy Treatments
As a leader in breakthrough discoveries for pediatric patients, it was also crucial that Children’s National Hospital find innovative ways to procure access to novel cell and gene therapy treatments, a complex and often arduous process. Clearway Health enabled the health system to achieve this goal by pioneering a model that executed and accelerated the payor, legal and procurement processes for these new types of cutting-edge therapies.
“With dozens of CGTs in the pipeline, the need for specialty pharmacy experts is likely to increase exponentially. This market has exploded,” Balmir said. “We’ve gone from treating symptoms to prolonging life. Now we’re at this curative phase, which is a big deal for pharmacy.”
Building and Opening a Hospital Owned Specialty Pharmacy
As part of the long-term approach to helping the health system specialty pharmacy program succeed, the partners embarked on a plan to reduce reliance on contract pharmacy arrangements through building and opening Children’s National Hospital’s own specialty pharmacy. Clearway Health guided the planning and building of Children’s National Hospital’s first specialty pharmacy, which opened in November 2024.
Owning a specialty pharmacy helps the hospital save money on dispensing fees they would otherwise pay to contracted pharmacies. It also creates a new service line for the hospital, an asset that has improved the health system’s margin and keeps the care of the patient within the healthcare system, improving clinical outcomes and reducing costs.
Download the full case study to learn more how Clearway Health partnered with Children’s National Hospital to build an on-site specialty pharmacy that improved financial strain, labor shortages and access to affordable medications.