McKesson ideaShare 2026: Building Specialty and Infusion Capacity From the Ground Up

As specialty drug spending continues to reshape the pharmacy landscape, independent pharmacy owners are increasingly asking whether—and how—they can compete in this market. At McKesson ideaShare 2026, taking place June 18–21, 2026, in Denver, Colorado, a Pharma Talk session titled "Diversification Through Specialty and Infusion Services" offered a candid, practitioner-level answer. The session was moderated by Chinedu Okocha, vice president of pharmacy retail operations at McKesson, and featured Laleh Ford, PharmD, pharmacist in charge at CDM Drugs in Coronado del Mar, California, and Mona Farghaly, PharmD, president of CarePlus Pharmacy, a multi-location operation spanning Pasadena and Houston, Texas.¹

Their message was consistent: the path is demanding, but the opportunity—for patient outcomes and business sustainability—is significant.¹

A Market Worth Pursuing

The urgency behind that message is backed by market data. The specialty pharmaceuticals market grew from $92 billion in 2023 to $129 billion in 2024 and is projected to expand at a compound annual growth rate of nearly 40%, potentially approaching $1 trillion by 2030. Yet despite this growth, dispensing remains highly concentrated; in 2024, the 3 largest specialty pharmacies generated two-thirds of all prescription revenues from pharmacy-dispensed specialty drugs.^2,3

This environment represents both a challenge and an opportunity for independent pharmacies willing to build the infrastructure to compete.

What Drew Them to Specialty

For Ford, the impetus was patient demand. Patients were coming to her pharmacy asking about specialty medications, sometimes requesting guidance on how to self-administer injectables—services her pharmacy was not yet equipped to provide. That pattern prompted her to conduct due diligence on whether entering the specialty space made sense for her community and her business.¹

Farghaly's path emerged from a more frustrating operational reality. Her pharmacy, rooted in long-term care (LTC) and mental health, was already managing complex medication therapy for patients whose care plans included specialty drugs. When a prescription required a specialty pharmacy contract she didn't yet hold, she was forced to transfer it out, only to discover that the receiving pharmacy would then contact her patients and attempt to absorb their entire prescription profiles. The business she had built was being eroded from the outside.¹

"When you have a comprehensive continuity of care, I see that huge impact on our patients—and on our team and me,” Farghaly said. Rather than continuing to cede that ground, she built the capability to keep it in-house.¹

Counting the Costs Before You Commit

Both panelists were direct about the reality of what entry into specialty dispensing requires: it is not a light lift. Accreditation, payer contracting, compliance infrastructure, and staffing can all carry significant cost and complexity.

"This process is really costly and really complicated," Ford said. "Sit down and evaluate if it is worth it for you." For Ford, that evaluation involved confirming that enough prescribers in her area were writing specialty prescriptions, that a sufficient patient population existed, and that the financial case held up under scrutiny.¹

Farghaly approached the decision through a similar lens but added a layer of strategic sequencing. Rather than attempting to build a full infusion center immediately, she launched on the specialty dispensing side first, where the barrier to entry is lower and her familiarity with local provider needs helped guide the initial effort. That phased approach allowed her to evaluate needs before moving to the next phase: sterile room construction, engineering certification, and infusion accreditation.¹

"It's not easy—sometimes it's overwhelming—but it's really rewarding," Farghaly said.¹

Building the Infrastructure Piece by Piece

One of the most transferable lessons from the session was Farghaly's framework for scaling deliberately. She advised approaching expansion one disease area at a time, one drug at a time, one provider at a time, mastering each step before moving to the next.¹

Ford pointed to physician outreach as a critical and often underutilized tool. She noted that McKesson offers resources to help identify prescribers in a region who are already writing specialty prescriptions, which can help pharmacies build referral relationships before committing fully to the infrastructure investment.¹

“There are a lot of things to sit down and talk about," Ford said, "but it's good to give comprehensive care to one patient so they don't have to go different places for different medications. That was the reason why I ultimately decided to move forward."¹

She also emphasized that pharmacists hold a distinct advantage when meeting with physicians that sales representatives do not: clinical credibility. Offering to handle prior authorizations, manage lab monitoring, and take administrative burden off a busy practice can open referral pipelines that are difficult to access through other channels.¹

The Patient and Business Case

The session moderator asked both panelists to reflect on what had changed after adding specialty and infusion to their service mix. For Farghaly, the answer centered on the ability to see patients holistically.¹

When a pharmacy manages a patient's entire medication profile, including specialty agents, it can identify drug interactions that might otherwise go unnoticed when prescriptions are split across multiple dispensing locations. Providers, she noted, began returning to her team not just for fills but for clinical input. "The pharmacist is the bucket," Farghaly said. "We can save lives on that."¹

On the business side, both panelists acknowledged that specialty dispensing is not without friction. Ford noted that even with full accreditation, some insurers designate exclusive specialty pharmacy networks that independent pharmacies cannot access. Payer access remains an ongoing challenge.¹

Still, for the patient populations both pharmacists serve, the combined impact on care quality and financial performance has validated the investment.

For pharmacy owners considering the move, Farghaly's advice was grounded in what already exists within a practice. "Look at the unmet needs of your current patient population," she said. "Fill in those gaps before you start chasing any new service opportunity."¹

REFERENCES

1. Ford L, Farghaly M. Diversification through specialty and infusion services. Pharma Talk presented at: McKesson ideaShare 2026; June 20, 2026; Denver, CO. Accessed June 21, 2026 on ideaShare Virtual Platform.

2. Popowitz E.Top trends in specialty pharmacy. Definitive Healthcare. Published June 16, 2025. Accessed June 21, 2026. https://www.definitivehc.com/blog/specialty-rx-trends

3. Fein AJ. The top 15 specialty pharmacies of 2024: how PBMs, health systems, and independents are shaping the market. Drug Channels Institute. Published April 16, 2025. Accessed June 21, 2026. https://www.drugchannels.net/2025/04/the-top-15-specialty-pharmacies-of-2024.html