The Evolution of Specialty Pharmacy

David M. Suchanek, RPh
Published Online: Monday, February 20, 2012
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The growth of this field is dependent upon connecting stakeholders in a productive way.

Over the past 30 years, specialty pharmacy has grown from a notion to a niche industry to being on the brink of becoming the major force in health care delivery.

With the pipeline overflowing with specialty products and the days of big blockbuster brand products long gone, our focus leads to the future of pharmacy—spec ial ty pharmaceuticals. Overall, these products have had one thing in common since they were first introduced—they tend to present “challenges” to all the stakeholders: physicians, patients, payers, pharmacies, and manufacturers.

It is because of those challenges that I and others in the profession were drawn to provide “special” solutions for the marketplace. We chose to do what was truly “new,” what took us out of our comfort zone, what our patients needed. As our current health care system continues to change, it is important for pharmacists to do what some peers will not venture to do…evolve.

Many years ago, a patient walked into my pharmacy crying. She just got back from the oncologist and he told her something that she never wanted to hear—that she had an aggressive type of cancer and they needed to start treatment right away.

The physician handed her an Rx for a new medication. She had never heard of it and had no idea what she was going to go through that afternoon. She was simply told that she was going to have an RN visit her to show her how to inject the medication after her chemotherapy in a few days.

Frantically, she searched for the medication. She went to the 3 pharmacies in the “big town nearby the MD office” without any luck and finally landed in our store. We figured it out but it was not an easy endeavor. To add to the mix, she did not have a benefit for the medication and we had to resort to the new manufacturer assistance program.

In the end, we became good friends as she fought for the next decade before succumbing to the illness. This experience had a long-term impact on me. That day when we solved the problem of how to get the cancer medication for our dear customer, we decided to go down the path of specialty.

Specialty has been and continues to be about bringing “solutions” to the stakeholders and linking them cohesively together (Figure). It started simply with providing services to MD offices, manufacturers, payers, and patients.

It now has evolved to include REMS programs, 501c3 foundations, hospitals, home health/nursing services, infusion suites, wholesale, and HUB services. In the near future we expect to see integrated lab and genomic testing, media tool– driven adherence support services, and Web portals that empower patients to co-manage their disease with their health care team in a real-time environment. We all need to continue to evolve. PT 

David M. Suchanek, RPh, is senior vice president of biotech and specialty services at D2 Pharma Consulting, LLC, a  consulting firm which focuses exclusively on pharma services in the life sciences industry. Mr. Suchanek is a member of the Specialty Pharmacy Times editorial board. For more information, visit

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