The Expanding Role of the Specialty Pharmacist

Randi Hernandez, Associate Editor/Online
Published Online: Friday, November 8, 2013
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Cultivating a career in specialty pharmacy has never been more exciting.
One of the primary reasons there has been increased focus on specialty medications in the practice of pharmacy is that the average specialty medication costs 50 times more than the average traditional drug, according to a recent Prime Therapeutics’ Specialty Drug Trend Insights report. What’s more, specialty drug utilization is growing quickly, leading to more roles that will require a high-touch approach to patient management. As the medications in the pipeline become more specialized, the skill sets of pharmacists must expand and evolve to meet the needs of their patients initiating treatment with complex biologics.

Although specialty pharmacists can be found working at specialty pharmacies, there are many other career paths one can pursue with a concentration in specialty. These roles often involve opportunities in a more intensive clinical environment or rely on the business side of drug management. Here are some real-life examples of potential career paths for those interested in pursuing a concentration in specialty pharmacy.

Pharmaceutical Consultant

Once they are medication management experts, pharmacists often find themselves in consulting roles, either running their own consulting business or as an employee of a larger company. Those in this role help pharmaceutical companies and manufacturers optimize their commercial operations and help upper-level management craft “best practice” supply chain strategies. Pharmacists with interests in oncology may be especially valuable; as more and more expensive oral oncolytics enter the pipeline each year, managing the reimbursement and networks of these drugs will become increasingly challenging.

Product Access and Channel Management

Channel management executives supply integrated business solutions to manufacturers that help support a drug throughout its life cycle. The tasks associated with this type of senior, C-Suite level role can include monitoring and managing the relationships between specialty pharmacies and specialty drug manufacturers, overseeing contracting for specialty services, and the selling of ancillary services that support specialty products. Those interested in these roles normally have decades of experience, and are often tasked to make sense of advanced analytics and transform large amounts of data into actionable business decisions. This role and other similar distribution roles may also include managing the incorporation of a central specialty distribution network, retail distribution network, or a home care distribution network.

Compliance Manager at a Pharmaceutical Company

Many specialty therapies are associated with REMS programs, also known as risk evaluation and mitigation strategies. Pharmaceutical manufacturers are often required by the FDA to report certain data back to the agency, and a student with expertise in drug regulatory processes may have an advantage over other pharmacy students who have little background or training in pharmacy policy. A compliance manager essentially helps businesses evaluate and prioritize risk, as well as guides manufacturers (often with the help of a legal team) through the regulatory landscape. Many professionals in this type of setting also monitor product safety, handle surveillance reporting, and complete other activities associated with pharmacovigilance.

Clinical Editor in Clinical and Scientific Affairs

Pharmacists who have an interest in writing can land a position sharing their knowledge of specialty drugs by way of a career path with an editorial focus. Students who have particularly strong writing skills may find themselves at publishing companies, working for medical journals, or in business to business freelance positions. Credentials in specialty pharmacy, such as a specialization in HIV or oncology, may add to the credibility of the prose created by medical writers. Those with many years of experience in medical writing could eventually be excellent candidates for medical science liaison positions at pharmaceutical companies or within corporate departments of national pharmacy chains.

Clinical Consultant at a Pharmacy Benefit Manager or for a Health Plan

PharmD students not only have to know the standard of care for the treatment of chronic diseases, they also have to stay abreast of drugs in development that could have major impacts on future health outcomes. This involves being aware of pivotal Phase II and Phase III trial results, and predicting future specialty drug spend for a health plan or a pharmacy benefit manager. Often, decisions by pharmacists in this role are made based on drug pricing and patient utilization data, and conclusions regarding the “best” specialty drugs often influence formulary decisions at health plans. Pharmacists at health plans also work with the analytics teams to ensure clinical programs are executed according to contractual agreements and regulatory guidelines. Lastly, some clinical managers with payers develop marketing collateral to support the clinical program offerings at their companies.

Managed Care Sales Executive in Specialty Pharmacy

Although neither training in specialty pharmacy nor traditional pharmacy is required for a position in sales at a pharmaceutical company or a health insurance company, pharmacists are drug experts and can bring advanced knowledge and insight to sales roles. They often know how products are reimbursed, especially with regard to high-priced products that are covered under specialty tiers or are associated with coinsurance. Additionally, many in this role are responsible for building and managing a pipeline of new business development opportunities.

Specialty Pharmacy Buyer at a Large Retail Chain

Although the location of this position is not at a traditional pharmacy, many large retailers are now entering the specialty pharmacy space—many of these established companies need the help of a specialty pharmacist to develop and grow their “local” specialty pharmacy strategies, which have also been referred to as the “specialty at retail” approach. These positions are expected to arise with increased frequency as more players enter the specialty “game.” Pharmacists will likely be expected to help create a seamless customer experience for patients receiving specialty pharmacy medications in this type of environment.

Manager of Clinical Services at a Large Health System

340B-covered entities contract with specialty pharmacies to provide services for their patients, so a pharmacist in this setting will have to know the regulations surrounding 340B contracting. A manager in the pharmacy department may act as lead project manager in the development and implementation of policies and procedures surrounding gaining URAC accreditation for a health-system pharmacy. Clinical pharmacists need to incorporate evidence-based medicine in the development of the health system’s drug strategies and may be expected to develop programs educating physicians and patients on drug therapy. A manager in this setting must be able to exercise sound judgment when making decisions for all policies regarding prior authorization requests and oversee the documentation, reporting, and implementation of utilization plans as required by health plans, as well as supervise the reporting of adverse events via the FDA’s MedWatch program. In addition, a clinical pharmacist in a specialized health system often has additional credentials in a specific, chronic disease state (eg, an American Academy HIV Pharmacist credential).

Clinical Trial Operations Within a Drug Distribution Company

This position is one of the more unusual roles in the pharmacy industry, and is one that is still in its early stages. McKesson’s StudyLink program is a pharmacy-based patient recruiting model wherein pharmacists pull from a large pool of real-world patients for post approval prospective observational studies.

Although this method has only been utilized in the community pharmacy setting so far, it is only a matter of time before specialty pharmacists will become more heavily involved in the world of clinical trials. Specialty pharmacists already reach out to their patients more on average than community pharmacists with regard to adherence and adverse events. As a result of these frequent high-touch interactions with patients, specialty pharmacists could be the most qualified to target the right patients at the right time.


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