Expert: Targeted Approach of Specialty Drugs Drives Rising Prices

In an interview with Pharmacy Times at the 2023 Asembia Specialty Pharmacy Summit, Naveen Mansukhani, BPharm, director of Operations and Account Management for Retail Pharmacy Services at Cardinal Health, discussed skyrocketing prices for specialty drugs and what is driving those increases.

Q: Despite being just about 2% of overall prescription volume, specialty medications are now more than half of total annual pharmacy spending. Are there specific drug classes or disease states that are driving this issue?

Naveen Mansukhani, BPharm: Specialty drugs are very targeted drugs to targeted disease states. Inflammatory disorders, oncology, multiple sclerosis, those are just some of the drug classes that are currently driving the specialty spend.

Q: What is driving such rapid increases in specialty drug prices?

Naveen Mansukhani, BPharm: The rapid increases are really due to the targeted approach specialty drugs have. Specialty drugs also require special handling and special follow up to to ensure compliance for patients, so, partly, the storage requirements and how to get it into a patient's hands is what's driving costs.

Q: What are the impacts of such high costs on the US health system and on patients?

Naveen Mansukhani, BPharm: Hospitals are under continuous pressure to save costs. They're always looking to how do we save costs on the drugs. And the more that you try to save costs, you end up impacting patient care and quality care at some point. So, these are the pressures that are on hospitals today and causing them to look at other strategies to get specialty drugs in patients’ hands. From a patient perspective, they’re just delaying treatment because of the high cost of drug. And that's where specialty pharmacists play a very important role in ensuring the patient understands the reasons for taking a drug, how to take a drug, diagnose those side effects, and ensuring that we have a better compliance and outcomes.

Q: What steps can health systems take internally to address or manage this issue?

Naveen Mansukhani, BPharm: I think it's more of a collaborative approach to look at the different areas, to not just look at it from one point of view, which is just the pharmacy’s point of view of controlling drug costs. It's also about the people billing the medications and ensuring that we have the right indications for a drug to get paid. So, this collaborative approach within a hospital will help get that done.

Q: What role do pharmacists play in helping patients afford their specialty medications?

Naveen Mansukhani, BPharm: Especially from a retail perspective, retail pharmacists play a very important role in not only the understanding of a patient but also enrolling them in special programs, copay assistance programs, manufacturer programs to help a patient afford medication. And then also explaining to the patient why they're using this drug, what it's for, what are the side effects, who to go to when they're having side effects, and just that follow up to ensure that they're going to get the best possible care and the best possible outcomes.