CSP - Certified Specialty Pharmacist Specialty Pharmacy Operations and Workflow Questions and Answers Flashcards
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Which accreditation body specifically developed standards for specialty pharmacy practice in the United States?
Answer: URAC
URAC was the first accreditation body to develop specialty pharmacy-specific standards and remains a leading accreditor in the specialty pharmacy space.
A specialty pharmacy receives a prior authorization (PA) denial for a biologic agent. What is the most appropriate FIRST step?
Answer: Initiate a peer-to-peer review request with the prescriber's office
A peer-to-peer review allows the prescriber to discuss the clinical necessity directly with the payer's medical reviewer, which is typically the most effective first step in overturning a PA denial.
What does the term 'hub services' refer to in specialty pharmacy?
Answer: Manufacturer-sponsored programs providing patient support, benefits investigation, and PA assistance
Hub services are manufacturer-sponsored patient support programs that assist with benefits verification, prior authorization, copay assistance, and patient education for specific specialty products.
Which metric is most commonly used to evaluate specialty pharmacy dispensing efficiency and patient safety?
Answer: Medication error rate per 1,000 prescriptions
Medication error rate per 1,000 prescriptions is a key safety metric that specialty pharmacies track to identify process breakdowns and prioritize quality improvement efforts.
A specialty pharmacy's limited distribution drug (LDD) contract requires it to report dispensing data to the manufacturer monthly. This is BEST described as a requirement of which program type?
Answer: Limited Distribution Network (LDN) agreement
Limited Distribution Network agreements between manufacturers and select specialty pharmacies typically include data reporting obligations as a condition of participation.
What is the primary purpose of a cold chain audit in specialty pharmacy operations?
Answer: To ensure temperature-sensitive medications were maintained within required ranges during shipping
Cold chain audits verify that temperature-sensitive biologics and other specialty products remained within required temperature ranges from manufacturer to patient, protecting drug integrity and patient safety.