By Katie Bahr
After working as the Director of Pharmacy for a couple different organizations, Jerry Buller (MMHC’16) started a specialty pharmacy at Vanderbilt University Medical Center in 2011. Newer specialty drugs enable patients to receive treatments such as chemotherapy in the comfort of their own homes but require a high-touch clinical service and infrastructure that can be cost prohibitive for traditional pharmacies.
“That’s where a specialty pharmacy comes in,” Buller said. “Specialty pharmacies started to appear in the 1980s with newer IV therapies and the advent of home infusion. However, in the late 1990s, the development of newer biologic therapies and oral cancer agents propelled this business into a new dimension.”
When he initially joined VUMC, Buller describes his background as a pharmacist who knew a little bit about business. “I knew what a good specialty pharmacy looked like, but building one from scratch is hard,” he said. “We launched our specialty pharmacy with initial success. However, we knew to get to the next level, we needed help.”
At the time, the health system CEO engaged consultants to help the pharmacy with infrastructure and governance. The consultants opened Buller’s eyes to a new mindset of how to build a business. Their expertise, especially their knowledge of operations, inspired Buller to enroll in Vanderbilt’s Master of Management in Health Care (MMHC).
“When I heard about the MMHC, I saw that the course work was pretty much what these guys from the consulting firms had in their back pocket,” he said. “I thought man, these guys are sharp. I really wanted to learn more and approach problems like they did.”
While pursuing his MMHC, Buller took the torch from the consultants and grew Vanderbilt’s specialty pharmacy three-fold after he graduated. For him, the greatest benefit of the program was learning to create efficient operations.
“We had six people working in our call center, the heart of our operations, when I started,” Buller said. “While attending the MMHC program, we combined with an additional specialty pharmacy and were able to reduce the staff required by 33 percent — down to four people — and were realizing even better metrics. The tools I learned in the MMHC were revolutionary to me.”
Having a revolutionary mindset has been pivotal to Buller in a field that is changing the pharmaceutical market. A few years after obtaining his MMHC, he joined the start-up company Trellis Rx, which helps health systems create specialty pharmacies, as the chief pharmacy officer.
“Specialty drugs only make up about 3 percent of what’s prescribed, but by the year 2020, 50 percent of drug pharmaceuticals will be spent on specialty drugs,” Buller says. “Specialty pharmacies are a tremendous opportunity, but it’s hard for hospitals to fund, operationalize, and assume financial risk to develop them.”
Trellis Rx takes on that risk, paying for the employees and infrastructure to get a specialty pharmacy going rapidly in exchange for a small percentage of revenue. The company aims to change the way patients experience specialty pharmacies and expects to have 20 partners by the end of 2020.
Building a business in a growing market was a challenge Buller had been tackling since he began working with specialty pharmacies. But the MMHC coursework helped him to excel in a small, growing company as opposed to an academic medical center.
“It’s a team effort, not a hierarchy, in a start-up,” Buller says. “We have to discuss and collaborate as a team, which is really different from the setting I was used to. I gained a tremendous amount of experience working in teams during the Vanderbilt MMHC. You also have to choose your brand and what you want to be good at. The MMHC taught me how to focus on your market and differentiate, which is so important to a start-up.”