Our specialty pharmacy readers are amongst the most informed in health care.
As Directions in Specialty Pharmacy (formerly Specialty Pharmacy Times) enters its second decade, we are proud of our publication’s continuing role in educating the marketplace on specialty. Our specialty pharmacy readers are amongst the most informed in health care.
One of our publication goals is to be your ‘go to’ resource for evolving trends. To stay on top of those trends, we urge you resister on our website www.pharmacytimes.com or 1 of our social media channels to receive our industry-focused emails and other information resources. You can get real time updates on the business and profession of specialty pharmacy and specialty products.
Below are specialty pharmacy’s top trends:
New Specialty Products and Continued Growth
Specialty pharmacy became a reality as the result of the emergence of new drug approvals for disease states that lacked adequate therapy or no therapy at all. These new therapies have resulted in eradicating diseases, or extending the lives or quality of those lives of millions of individuals. Specialty products have given hope and relief, and our specialty industry continues to expand and evolve as a result new drug approvals.
Expect that over the course of the next several years products in the categories of oncology, autoimmune disorders, and diabetes will drive therapeutic growth. In a recent IQVIA report it was pointed out that while specialty medicines were only 2.2% of prescription volume it is projected that by the end of 2020 specialty medications will account for nearly 50% of the nation’s drug spending.1
The follwing are few examples of specialty products that should be a part of our future if approved:2
The cornerstone of specialty pharmacy accreditation is the establishment of policies and procedures that provide compliance with set standards placing patients first in terms of focusing on optimizing health outcomes, and guides them through complicated therapy management. It has become a standard for both payers and manufacturers that demand evidence of meeting critical standards.
Accreditation has solidly become a must if a specialty pharmacy desires to have access to a limited-distribution product. Payers likewise have set accreditation standards around quality, controlling costs, and documenting positive patient outcomes. As a result, accreditation is necessary to be ‘in-network’ for specialty products. There will be an increasing demand to have obtained accreditation by 2 or more bodies in order to obtain access to both the product and payer space.
Hospital Specialty Pharmacy Growth
As the lines continue to blur between the various flavors of pharmacy, hospitals in particular have experienced tremendous new growth As a result of the expanding portfolio of specialty products, we are seeing hospitals integrate with medical practices, infusion centers, and home care, and forming new variants of specialty pharmacy to create sophisticated networks delivering comprehensive patient care. For a variety of reasons, including access to limited distribution products, and 340B pricing, hospitals continue to establish their own specialty pharmacies or expand their existing capabilities to include specialty. Nearly all of these hospital-based specialty pharmacies take the step of obtaining accreditation to meet manufacturers’ and payers’ standards of care.
All 3 of the major Group Purchasing Organizations (GPOs) have developed solutions to assist their members in this space. Much of the shift has been because of the trends around decreasing reimbursement for Part B products in the physician office setting, and 340 B pricing often availed to hospital-based outpatient specialty pharmacies. These pharmacies are in a strong position to provide a continuity of care through integrated systems and data sharing, and coordinating care with Accountable Care Organizations (ACOs) that may participate in risk-based contracting. Keeping patients in a closed ecosystem provides a greater level of control and accountability.
In the traditional inpatient hospital model, patients are released from the hospital only to receive their outpatient drug services from traditional entities, such as retail and specialty pharmacy. The shift to hospital specialty facilitates a setting where orders are kept inhouse, resulting in increased revenues and potential profitability.
Value Based Contracting
New and costlier therapies demand innovation in the way products are paid for by plan sponsors. In order to assure access to these therapies, the market has turned to value-based reimbursement models. Attend a professional conference and you will see a multitude of presenters speaking on the topic of value-based contracting. A few organizations have taken the plunge.
In 2020, specialty pharmacies must embrace initiatives to quantify improved clinical outcomes, lower costs, and create more value for all stakeholders to obtain maximum compensation for their services. Likewise, manufacturers are being forced to put ‘skin in the game’ to assure their products create value for patients, providers, and payers.
Artificial Intelligence has changed the manner of how research and development takes place, and how products get approved. What was done purely in the laboratory in the past is now more often done through modeling and algorithms. Computers today can ‘crunch’ the data on countless pages of scientific literature, and that information accelerates the development of new medications.
Pharmacies are leveraging the power of mobile health apps to reach out to patients, and industry uses these tools to gather accurate information on the status of a patient’s health that drive the development of new drugs. Printable medication also has become a reality, and expect this technology to pave the way for the future of drug development, and to lower the cost for manufacturing drugs.
There are many more trends we could comment on. Please stay tuned to Directions in Specialty Pharmacy as we are THE journal fully committed to setting the publication standard through peer-written and reviewed articles focused on the ‘real world’ of specialty pharmacy practice.
We welcome your feedback on this topic and on any topics, you would like us to cover in future editions of Directions in Specialty Pharmacy. Please reach out to Dan Steiber at firstname.lastname@example.org.