Exploring the links between specialty pharmacy and mental health

Specialty Pharmacy is deeply committed to providing treatment for high-risk conditions for mental health issues.

Mental health and specialty pharmacy overlap in important, sometimes difficult ways. To support further exploration of these connections, Shields Health Solutions (ShieldsRx) recently participated in a mental health thought leadership discussion as part of the Alliance for Health Policy’s 2022 Signature Series. Supporting and participating in the Nonprofit, Nonpartisan Health Policy Alliance Signature Series is an opportunity to educate policy makers on ShieldsRx’s mission to improve health outcomes for complex patients .

The year-long series will explore the breadth and depth of mental health in the United States in 3 main areas – innovation, delivery and access – while examining implications for health equity In all areas.

At the series launch event, a thought leadership discussion that took place via Zoom on April 14, ShieldsRx was represented by Chrissy Kendrick, SPHR, Senior Director of Human Resources, and Kristen Ditch, PharmD, BCCCP, Clinical Outcomes Manager, who spoke about the impact of integrated specialty pharmacy on mental health care. This interactive, invitation-only session for thought leaders, experts and decision-makers from across the healthcare ecosystem focused on high-level ideas and brainstorming as the basis for future discussions and recommendations.

The series will conclude with a public congressional briefing in December and a written summary intended to be an action-oriented guide for the broader health policy community.

In the context of an integrated health system, specialty pharmacy touches patients throughout their journey. Particularly in the case of high-risk medications or therapies, specialty pharmacy staff are engaged in screening patients for mental health issues and identifying instances where the medication itself may increase risk. mental health issues and monitors these risks as part of the referral process. the patient comprehensively and holistically.

The specialty pharmacy is also deeply committed to treating high-risk conditions for mental health issues, including autoimmune diseases, cancer, HIV/AIDS, multiple sclerosis, Parkinson’s disease (PD) and opioid disorders. A diagnosis of PD itself puts the patient at higher risk for depression and psychosis, but therapies alone can also increase the risk of psychosis if antipsychotics are not properly reduced.

A study from Vanderbilt University Medical Center found that integrating a specialty pharmacist into a neurology clinic reduced the median time to approval for pimavanserin, an antipsychotic agent for the treatment of PD-related psychosis, by 22 days before integration to 3 days after integration.1 The third-party approval rate increased from 81% to 95%, and the treatment initiation rate increased from 78% to 94%.

Access to pimavanserin requires navigating a limited distribution network and insurance approvals, which specialty pharmacy integration makes more manageable for patients, their family caregivers, and clinic staff. Once treatment is initiated, specialty pharmacy staff monitor safety and effectiveness to ensure compliance, management of adverse effects – including those that put the patient at higher risk for mental health issues – and clinical benefits.

Mental health is also a human resources concern. Having been on the front lines of the COVID-19 pandemic, specialty pharmacists in the healthcare system are at high risk of burnout and other mental health issues.

Healthcare employers are facing new challenges in providing mental health benefits and services to their employees, who have experienced increased stress and isolation working in virtual environments, added stress due to pandemic and an exposure to loss and grief, not only in terms of the patients they treat and perhaps their own loved ones, but mourning the loss of colleagues, as so many others in the health sector have lived since the beginning of 2020.

As the first specialty pharmacy accelerator in the United States, ShieldsRx recognizes that patients, pharmacists, and other healthcare workers all face mental health challenges. Our integrated care model emphasizes access to higher quality care for more patients through a dedicated team of specialty pharmacy experts, a proven collaborative care model that includes pharmacists, pharmacy liaison officers and patient advocates, and integrated technology solutions.


1. Livezey S, Shah NB, McCormick R, DeClercq J, Choi L, Zuckerman AD. The integration of a specialist pharmacist in an outpatient neurology clinic improves access to pimavanserin. mental health clinic [Internet]. 2021;11(3):187-93. DOI: 10.9740/mhc.2021.05.187.