Q&A: Pharmacists’ Role in Helping Patients Manage Ultra-High-Cost Drugs
Erin Fox, PharmD, MHA, BCPS, FASHP, joined Drug Topics to explore ultra-high-cost drugs and pharmacists’ role in managing patients’ prescription regimens.
Pharmacists have the unique ability to educate patients and payers about the importance of ultra-high-cost drugs and how to properly manage them. With pharmacists’ expertise on the functions of specific drugs among various patient populations, they too are the leading authority on this unique class of medication that is considered rare but necessary.
According to Erin Fox, PharmD, MHA, BCPS, FASHP, co-author of the American Society of Health-System Pharmacists (ASHP) 2025 Pharmacy Forecast, pharmacists’ passion for gaining further expertise in specific areas of health care is what sets them apart as front-line providers. Furthermore, she believes that this expertise has allowed pharmacists to create a better patient-provider relationship unlike those of the past.
“Many pharmacists are becoming very much experts in very niche areas. Capitalizing on that can actually help the providers have those types of conversations with more patients,” she told Drug Topics.
Within the ASHP’s 2025 Pharmacy Forecast, Fox helped co-author a section titled “Managing Ultra-High-Cost Drugs.” | image credit: joeycheung / stock.adobe.com
Within the ASHP’s 2025 Pharmacy Forecast, Fox helped co-author a section titled “Managing Ultra-High-Cost Drugs.” She joined Drug Topics to dive deeper into this section of the report and discuss the nuances of ultra-high-cost drugs in the pharmaceutical supply chain.
READ MORE: Q&A: Ultra-High-Cost Drugs Highlight Complex US Health Care System
Stay tuned for more Drug Topics interviews regarding the 2025 Pharmacy Forecast. As we meet with authors and industry leaders that contributed to the report, we will discuss some of its main sections.
Drug Topics: Moving to providers that are most familiar with ultra-high-cost drugs, how can pharmacists leverage their knowledge of these medications and assist patients struggling for prescription drug access?
Erin Fox: I think deciding if one of these treatments is right for a patient, pharmacists can really help play a role there, working in tandem with the physician. Thinking about side effects, what the overall treatment regimen would be like, helping talk through those issues with the patient can be really important. Talking about the other alternatives, the steps that you might take with other treatments before you get to this ultra-high-cost drug.
Pharmacists have such a role to play in all those conversations, and many pharmacists are becoming very much experts in very niche areas. Capitalizing on that can actually help the providers have those types of conversations with more patients.
Drug Topics: Do you believe that pharmacists can be doing more in regard to helping patients facilitate the ultra-high costs of certain medications?
Erin Fox: I think becoming more involved in contracting discussions is a new role for pharmacists, but [it’s] really helping have those conversations with the payer, with the health system, and kind of having that big, big picture view. Pharmacists can help patients end up being able to access those products, if we can think of good terms that are agreeable to [the] payer as well as the health system.
Pharmacists uniquely—maybe even different than providers—are very familiar with the payer side as well as the clinical side. I think that ability to have that broad view makes them a really helpful asset to the folks at the health system that might be working on that specific contract.
Drug Topics: With so many issues within health care, and pharmacy specifically, why is it important for pharmacists to be knowledgeable about these ultra-high-cost medications that impact so few of their patients?
Erin Fox: At the most basic, I think it's important to know these exist because you might encounter a patient in your practice. But it's very important for you to understand that they've received that treatment, so that you don't give another therapy that could counteract or more adversely affect the patient, and just kind of help understand the side effects that those patients are going through.
Even though you might not have been involved in that actual treatment with the ultra-high-cost drug. It's really important to understand that it exists, again, to just help provide that overall care and education for the patient.
READ MORE: Health System Resource Center
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