Chicago Children Goes Off-Site for Specialty Pharmacy Build

By Karen Blum

The pharmacy team at the Ann and Robert H. Lurie Children’s Hospital of Chicago had been looking to build their own specialty pharmacy for several years, but space and resource limitations were preventing them from moving forward, said Jenny Elhadary, PharmD, the vice president of clinical services and senior director of pharmacy at Lurie Children’s. Partnering with vendor Clearway Health helped them find a good location and start construction.

“We knew that building a specialty pharmacy would enable us to expand our reach and deliver life-changing support for our patients, because we see so many patients with complex conditions,” Dr. Elhadary said. Those conditions, which include cancer, autoimmune diseases, genetic disorders and hemophilia, all require patient-specific care coordination.

She and her colleagues knew they couldn’t fit a new pharmacy within their main 22-floor hospital in the middle of downtown, she said. They considered using part of the building next door, but that was more of an office building and not patient-pacing or family friendly, she said.

So the team decided to partner with Clearway Health, a specialty pharmacy vendor, to get the job done. After looking around, pharmacist experts with the company helped identify a large space perfect for growth: In a 75,000-square-foot outpatient and infusion center the hospital was building in the suburb of Schaumburg, about 25 miles outside Chicago.

The 2,053-square-foot space, in the building’s third floor, is designed to ship medications to patients and work with families who may present in person, said Dan Zorrilla, the hospital’s senior director of design and construction. The footprint incorporates a small waiting room, transaction counter, a consultation room and a large processing area where medications will be stored, as well as a packaging and shipping area, small compounding area, and a manager’s office. Construction is estimated to be completed by the end of the year, with a plan to launch the pharmacy by spring 2026 following licensure and payor contracting, said Loan Nguyen, PharmD, the manager of pharmacy operations at Clearway Health.

Pharmacists anticipate processing 5,000 to 10,000 prescriptions in the first year, growing to more than 20,000 by the second year, Dr. Nguyen said.

“Usually it’s ideal to have a specialty pharmacy within or near a hospital” to streamline a patient care journey, she said. “However, hospital and health systems face space constraints that make this a bit challenging.”

Specialty medications typically require prior authorization and financial assistance for patients, Dr. Nguyen said, delaying the dispensing by several days. “Patients don’t necessarily pick up the medication as soon as they see their provider. … The majority of the medications are being filled and delivered to patients’ homes. With that, the pharmacy space does not necessarily need to be in a high-foot-traffic area close by the hospital.”

Size Matters

A common mistake among health systems is to try to shoehorn their specialty pharmacy into a small, centrally located space, thinking they will handle low volumes, but then there isn’t room to grow, added Christopher Wilson, PharmD, the senior director of pharmacy operations at Clearway Health. Sometimes the better choice to garner more space and have room to grow is to look off-campus, he said. “There is no emergent specialty pharmaceutical that’s out there,” Dr. Wilson said. “Nobody wanders down from the oncologist’s office and picks up their therapy the same day. It’s just not how it’s done.”

Labor and resources were among the reasons the pharmacy selected an outside vendor to help, Dr. Elhadary said. “It’s a very complex process,” she said of launching a specialty pharmacy. “You have to look at space. You have to design the space. You have to build the space. You have to work with payors. You have to become accredited. There are so many different processes that it’s very difficult unless you have a lot of internal resources to [rely on].”

Clearway Health had experience building specialty pharmacies for other medical centers, including for Children’s National Hospital, in Washington, D.C., in fall 2024. Moreover, Lurie Children’s pharmacy team already had a relationship with Clearway Health, which provides pharmacist liaisons in the hospital’s pulmonary, cystic fibrosis, rheumatology, neurology, hematology/oncology and genetics clinics to help coordinate medication management for patients and their families. The pharmacists also provide medication education; oversee treatment assessments, monitoring and adherence; and complete benefits investigations, prior authorizations and help patients find financial assistance, if needed.

The specialty pharmacy also will be staffed by Clearway Health employees, Dr. Nguyen said. Once it opens, she envisions a seamless process for patients, as the pharmacist liaisons will communicate directly with the pharmacy to get patients’ medications processed in a timely manner.

“We were able to maximize the space in a brand-new building,” Dr. Elhadary said. “My ultimate goal is to be able to expand our program to more divisions as the need continues to grow in the specialty medication realm.”

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