Penn Specialty Pharmacy
A guide to specialty medications
Specialty medications treat complex or long-term conditions. Because they often need more support than regular prescriptions, these medications can only be filled through a specialty pharmacy. When your Penn Medicine provider prescribes a specialty medication, it’s sent to Penn Specialty Pharmacy.
We’ll enroll you in our specialty pharmacy service so we can help with insurance reviews, refills, and pharmacist support. Our role is to guide you through each step, from filling your prescription, to learning about your medicine, to understanding costs. Enrollment is optional, and you can choose to leave the service at any time by calling us.
Our services include:
- Help working with your insurance
- Education and ongoing pharmacist support
- Flexible delivery or pickup options
- Access to clinical support, including after-hours help
Getting your specialty medication
The process begins when your provider sends your prescription to Penn Specialty Pharmacy. You may also call us and ask that we contact your provider for a new prescription.
Once we receive your prescription, we usually process it within one to three business days. If your insurance needs more information, we will tell you and keep you updated.
A specialty pharmacy team member will contact you to plan how you’d like to receive your medication. Options may include:
- Picking it up at one of our outpatient pharmacies
- Receiving it during a clinic visit
- Having it delivered to your home
We help you stay on track with refills, so you don’t run out of medication.
- Refill planning: We’ll contact you before your medication runs out to check in and plan your next refill.
- Requesting refills: You can also call us at any time to request a refill.
- When refills are needed: If you’re out of refills, we’ll work with your provider to request a new prescription.
- Text message refill reminders: For some medications, we’ll send a text when it’s time to refill.
Delays can happen while your prescription is being processed, such as during insurance approval or due to medication supply. When this happens, we’ll contact you and work quickly to resolve the issue. You can also call us at any time to check the status of your prescription.
If your medication was scheduled to arrive but didn’t, call us right away. We’ll help find out what happened and make sure you don’t miss doses.
Some insurance plans require medication to be filled at a different pharmacy. In those cases, we’ll transfer your prescription and let you know. You may also choose to move your prescription to another specialty pharmacy. Call us and we’ll help with the transfer.
At times, a medication can’t be filled at Penn Specialty Pharmacy. When that happens, we’ll work with you and another specialty pharmacy to help you receive your medication without interruption. You can also request a transfer by contacting us, and we’ll help get the process started.
Insurance and cost support
Specialty medications can be expensive. We help you by explaining your coverage, handling paperwork, and looking for ways to lower your cost.
Our insurance technicians work directly with your insurance company and care team to review coverage for your medication. This often includes a prior authorization, which means your insurer asks for more information before approving the prescription. This review usually takes about 72 hours.
Here’s what to expect:
- When approved: We let you know and confirm whether your medication can be filled at Penn Specialty Pharmacy or needs to be filled at another pharmacy.
- When not approved: We notify you and your provider. Your care team may choose to appeal the decision with your insurance company.
The cost of specialty medications can vary based on your insurance plan, copay, and deductible. Once your prescription is ready, we’ll explain your expected cost. Cash pricing is also available upon request.
Our team looks for financial assistance programs that may help lower out-of-pocket costs and can answer questions about network coverage. If you qualify, our financial assistance staff will help with applications and enrollment.
Possible support options may include:
- Manufacturer assistance programs that offer reduced-cost or free medication
- Charitable foundations that help cover medication cost for eligible patients
- Penn Medicine Pharmacy Financial Assistance when outside programs aren’t available
- Payment plans to help spread costs over time
Pharmacist support and education
Our specialty pharmacy team is here to help you understand your medication and know where to turn when questions come up.
Starting a specialty medication can bring up questions. A pharmacist will call you to review your medication, explain how to take it, and talk through possible side effects. They’ll also check in to see how you’re doing and help with dosing questions or other concerns as you continue treatment.
In addition to your Penn Medicine care team, specialty pharmacists are available during clinic visits or by phone whenever you need guidance about your medication.
Questions don’t always come up during regular business hours. For after-hours or urgent concerns, call and ask to speak with a pharmacist. A member of the Penn Specialty Pharmacy team will reply to your message as soon as possible.
These simple tips can help you get the most benefit from your medication:
- Take your medication as directed: Follow your provider’s instructions for dose, timing, and length of treatment.
- Ask questions: If anything about your medication or condition is unclear, your pharmacist can help explain.
- Stay consistent: Try to take your medication at the same time each day, if instructed, to help build a routine.
- Let us know about changes: Tell your care team about the side effects, missed doses, or changes to your health.
Medication questions and safety
Problems don’t happen often, but it’s important to know what to do if something doesn’t feel right. Our pharmacy team is here to help. If you notice side effects or any problems, such as an error with your medication, contact the pharmacy or your provider.
Most side effects are known and listed with your medication. Sometimes, unexpected reactions can happen. Contact the pharmacy or your provider if you notice new or concerning symptoms. Call 911 or have someone take you to the nearest emergency room if you think a reaction is serious or life-threatening.
You can also report serious side effects to the FDA’s MedWatch program. Call us if you need help with the form.
Life gets busy, and missed doses can happen. If you miss a dose, talk with your pharmacist or provider about what to do next.
When you have unused or old medications, we’ll help you dispose of them safely. Don’t flush medications down the toilet or throw them in the trash.
Severe weather or other emergencies can limit access to medications. Planning ahead can help reduce stress.
- Request refills early when bad weather or emergencies are expected
- If deliveries are delayed, we’ll work with other pharmacies to help you get your medication
Call us at 1-844-736-6796 if you have any issues with your medication or service
For additional complaints, contact the Accreditation Commission for Healthcare at 1-855-937-2242 or the Department of Health at 1-800-254-5164 (Monday-Friday: 8 am – 4:30 pm) to file your complaint
Your rights and responsibilities
You play an important role in your care. Knowing your patient rights and responsibilities helps you stay informed, ask questions, and work closely with your care team.
You have the right to:
- Receive respectful, high-quality care in a private setting
- Have your personal health information protected according to state and federal law
- Understand your medications, possible side effects, and treatment options
- Learn about available financial assistance and your payment responsibilities
- Know the names and roles of staff members involved in your care
- Speak with a pharmacist or request to speak with a supervisor
- Receive information about the Penn Specialty Pharmacy Patient Management Program
- Choose not to participate or leave the program at any time
You’re responsible for:
- Providing accurate clinical, contract, and insurance information
- Letting us know when your address, phone number, and insurance changes
- Completing required forms when needed
- Taking medications as prescribed and reporting problems or side effects
- Informing your provider if you are participating in the patient management program
Your privacy matters to us. The HIPAA privacy rule protects your health information and explains how it may be used or shared, while giving you rights to understand and control your personal health information.
Support services and accessibility
Managing a complex or chronic health condition can be challenging. Having access to additional resources and support can make it easier to navigate care.
In addition to your specialty pharmacy care, Penn Medicine offers a range of support services:
- Social work services for emotional, financial, or care planning support
- Nutrition services to guide healthy eating and dietary needs
- Interpreter and translator services for language support
- Sign language interpreters available upon request
- Portable TTY for patients who are hearing impaired
- Documents in Braille for patients who are visually impaired
- Wheelchair access and handicapped parking
- Accessible restrooms throughout our facilities
We’re committed to meeting the health needs of the local communities we serve. We want to be sure you can find the people, places, and community resources that can help support you.
Locations
Our hospitals, multispecialty medical centers, pharmacies, labs and more offer outstanding, personalized care for patients all across the region.