Growing up as a teenager in the rolling hills of South Boston, Virginia, Amber Hudgins shadowed a pair of pharmacists at a local community drug store, where she quickly learned there’s a lot more to the job than simply filling prescriptions and answering a few questions. Treat patients like they’re part of your own family, her mentors explained.
A dozen years later, she’s calling on that wisdom daily as a specialty pharmacist at Novant Health in Winston-Salem, where she’s part of the care team making sure patients, many battling difficult diseases, are supported at every level.
Among them is Melissa K. Jones, a 51-year-old Mount Airy nurse struggling with a painful, debilitating case of psoriatic arthritis. She marveled at their first encounter when Hudgins systematically walked her through a complex new prescription, what to expect and how it might work for her.
“She spent 45 minutes or longer with me on the phone during my first visit,” Jones said. “I was nervous, very sick and really having a hard time. And this young lady really did treat me as if I was one of her family members. She reassured me about a lot of things I was really nervous about. It just gives me chill bumps when I think about it.”
As a specialty pharmacist, that’s Hudgins’ job. Novant Health specialty pharmacies differ from standard pharmacies in that they provide a high level of personal attention and 24/7 phone support while dispensing specialty medications for patients with complex conditions that demand sophisticated new drugs. Just as important: They help patients get the best price possible on medications with a price tag that can top the price of a new car in a single dose.
Hudgins’ job starts the moment the drug is prescribed. “I’m the first person they talk to before the medicine goes out the door,” she said. “I want to know what their goal is. I have to make sure they understand how the medicine works, what to expect with side effects and how long the medicine might take to have an effect.”
In some cases, the drug might be an injectable, so she talks them through possible anxiety around that, too. Plus, as someone who specializes in rheumatology, she prepares patients for the fact that they may need to try a few different drugs, or maybe even several, to find the right one. A lot of her patients, like Jones, are on biologics, a relatively new class of drugs that come from living organisms or their cells.
The medications have tremendous potential to provide relief for debilitating disease, but there can also be trial and error because each drug can have different effects with each patient. It’s a long way from pharmacy school where students learned that everything was black and white.
And that was the case for Jones, who was having frustrating reactions to one drug, then another.
“Once you’re in-practice everything can often be gray, so you have to find the sweet spot for people,” Hudgins, 30, said. Pharmacists call it treat-to-target. “It’s like the art to science,” Hudgins said.
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One way she’s constantly building on those skills is working in the clinic at Novant Health Rheumatology & Arthritis - Westbrook in Winston-Salem. Unlike some pharmacists who might spend all their time behind a counter, she’s consulting with patients, doctors and nurses face-to-face to learn what’s working and when a change might be in order.
But when it comes to counseling her new specialty pharmacy patients, she’s still part of a larger team serving patients. That includes the challenge of making sure patients can afford their prescriptions. Hudgins hands that piece over to medication management specialists at Novant Health, whose job is to comb through insurance policies, prior authorizations, co-pay cards, grants and other options to find the best price possible. “They do an amazing job,” she said.
For instance, a three-month dose of Skyrizi is a walloping $25,000 each. “I got the package and (saw the cash price) and I was like ‘Oh my God!’ She didn’t even tell me. They’ve all helped me tremendously,” Jones said. “I could not have done it if it had not been for all they did.”
At one point in her care, Jones’ Novant Health doctor left to join another organization, a common occurrence in health care. And after all she’d been through, Jones decided that she’d follow her to her new practice, which also frequently happens.
But Jones was not about to leave her pharmacist, Hudgins. “Every time we talked, it’s like picking up the conversation with a friend who knew how I was doing yesterday,” Jones said. “Why would I want to start over with someone else?”
