How Is NASP Evolving with the Pharmacy Profession?


Mike Agostino, RPh, President of the National Association of Specialty Pharmacy (NASP), discusses how NASP has grown to meet the evolving needs of the pharmacy profession.

At the 2018 National Association of Specialty Pharmacy (NASP) Annual Meeting and Educational Conference,

Mike Agostino, RPh, President of NASP, discussed how the organization has grown to meet the evolving needs of the pharmacy profession.


There’s something I think about the profession that we’ve inherited along the way. And I say that because it seems as if the pharmacy profession in particular, in my opinion only, could have done a better job of speaking up. So in other words, if something was not fair but yet we were providing a value at, we were providing services in good faith and it just didn’t meet an expectation that was, at minimum, fair. Whether that be a reimbursement issue, whether that be an access issue, or all of the above. Sometimes I think it was the sentiment that ‘I’m just going to accept it and move on’. Well, I think times have changed. And that was part of the genesis of why NASP was formed because at the end of the day the profession of pharmacy is changing. One example is we’ve got a robust pipeline that is introducing more and more products that are falling into a specialty category, whether that be orphan based or not. If you look at the trend today of overall cost, you know last year, Medicare as a benchmark had about 40% specialty drug spend. This year the trend was 45%. So I mean if we do the math, right, and when we think about the projection of how specialty is growing: 1. it’s not going away, 2. the medications are becoming incredibly complex, yet very effective but yet they seem to emerging for much more smaller populations. So what that says to me is: 1. We’ve got a growing sense of practice that is going to change, it’s going to require more subject matter of expertise. And as a result, I think it’s imperative and sort of thankfully that NASP evolved and met this at the right time, maybe we were a little late, but we’re here now. And we have a venue where those that are practicing pharmacy, whether they want to focus on specialty or not, the reality is that that will become a prevailing portion of the practice of pharmacy. So when pharmacy turns from 45% maybe to 51%, maybe to 55%, we don’t know where that’s going to end, but if it’s greater than the majority then does it really just become pharmacy? The practice of pharmacy. And I think right now having the body that focuses exactly on what’s happening in our industry relative to the change, and the expectations of our profession, and the value that we bring to overall ecosystem of health care, now could not be a more appropriate time to get involved and get engaged. And to have the platform to do just that, I’m kind of thankful for that. As an owner/operator, honestly just 6-7 years ago, I didn’t have a NASP to lean on and I actually hired my own lobbyist because there were some things I felt like I wanted to change and I felt like I could do it. That was the fire in my belly to get more active at the level of not just the state, but also to here in Washington, DC. But then lo and behold, things changed and we all started to come together to try to unify our voice and to try to work a little bit smarter and not harder. So, I think it’s a great opportunity for those that really want to make a difference, want to maintain an open fairness, but yet are still willing to perform. I think that’s the key here. We’re not about just saying things have to change without any skin on the table for us, as NASP members and as practitioners. We’re willing to say, and I could tell you my membership is willing to say, ‘you know what, as long as it’s fair for us and we have access to treat a patient, we’re okay with performing’. As long as those performance expectations are reasonable and provide value and incentivize to those to just want to do better. It’s really not that difficult, but that’s what we’re fighting for.

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