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Nationwide Children’s Cystic Fibrosis and Specialty Pharmacy: When You Need Medication, Everything Matters

A Message from Emily Middleton, PharmD, Advanced Patient Care Pharmacist
Nationwide Children's Cystic Fibrosis and Specialty Pharmacy

In July 2015, I was assigned the task of opening a Specialty Pharmacy at Nationwide Children's to serve patients with Cystic Fibrosis (CF). It’s not hard to imagine that the thought of opening a specialty pharmacy specializing in CF was a bit daunting for me. While I had seen patients with CF at the pharmacy window at Nationwide Children's and learned about the disease in pharmacy school, I did not yet have a full understanding of the barriers patients and families encounter while trying to manage their medications. Lucky for me, I had the help of an extremely dedicated pharmacy technician, LaShae Bowe. It did not take long for LaShae and me to encounter people who had experienced difficulty getting their CF medications. Due to the nature of the disease and the need for many medications to treat CF, patients face unique challenges in managing their medications, insurance restrictions on medication coverage, and their overall quality of life. Adherence to medications (taking medications as prescribed)is one of the most effective ways to prevent progression of CF and difficulty accessing medications is one of the most common reasons doses are missed. Listed here are some barriers to adherence, and how NCH Specialty Pharmacy can help: 

Barrier to Access/Adherence

How Nationwide Specialty Pharmacy Can Help

Prior Authorization (PA) –when the insurance company needs more information in order to pay for your medication.

  • We can quickly identify that more information is needed and  since we are directly linked to the CF Clinic we can make sure PA’s are resolved in a timely manner.
  • We have a clinical pharmacist in the CF Clinic who works side-by-side with the prescribers.
  • Most prior authorizations are completed same day.

Limited distribution medications – when drug manufacturers only allow certain pharmacies to dispense medications.

We have access to all limited distribution CF medications (which is not the case for most specialty pharmacies).

Multiple Pharmacies – when medications are filled at more than one pharmacy leading to more time spent refilling medications and higher risk for drug interactions.

  • We can work with you to reduce the number of pharmacies you use to fill your medications even if your insurance has a preferred pharmacy.
  • Reducing the number of pharmacies used by a patient reduces the risk of medication errors.


High co-pays or no insurance

  • We can help you enroll in patient assistance programs to reduce your co-pays.
  • If you do not have insurance, we can connect you with programs to make sure you have the medications you need.

Needing to be home all day to receive deliveries

While we do require signatures for deliveries . . .

  • If delivery is preferred, we work with your schedule and can provide a 4-hour window when you can expect the delivery if needed.
  • Medications may also be picked up at the hospital: 8am to midnight Monday through Friday and 9am – 7pm on the weekend!

Need for immediate treatment – when you are ill and need to start an antibiotic right away.

While other specialty pharmacies may take days to weeks to send out treatment doses, we get these medications to you same day whenever possible.

Forgetting to call for refills

  • We call our specialty pharmacy patients 7 days before refills are due in order to prevent missed doses and resolve any insurance issues ahead of time
  • We can request refills from Nationwide Children’s Pulmonary Clinic for you.

Difficulty taking medications as prescribed

We monitor medication adherence and can work with you to set adherence goals and suggest tools to reduce the number of missed doses.

Medication interactions and incorrect use

A pharmacist trained in CF will review your medication list with you at least every three months to ensure your medications are working the best they can for you.

It has been incredibly humbling and rewarding to be welcomed as a part of the CF Care Team at Nationwide Children’s. In this short time, our Specialty Pharmacy staff has grown from two to eight and we are working hard every day to help make adherence to medication easier. Because we care about all patients with CF at our center, even if your insurance will not let you fill with us, we are always willing to help you with any medication question you might have. 

Specialty Pharmacy staff are available Monday through Friday 9 a.m. to 5 p.m. by calling (614)722-2534.

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Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000