New Era Brings Uncertainty to Specialty Pharmacy

Specialty Pharmacy Times, November/December 2016, Volume 7, Issue 6

On the heels of the most contentious election season in recent memory, 2017 will usher in a new era in the United States under President-elect Donald Trump, which should feature significant reform to myriad issues surrounding the Affordable Care Act (ACA).

During his campaign, Trump vowed repeatedly to repeal the ACA, but has since softened his stance, indicating that he may maintain a provision that forces insurers to cover pre-existing conditions, and another provision that allows individuals to remain on their parents’ health plans until their mid-20s. Regardless of the scope of the potential reforms to the current health care system, specialty pharmacies will undoubtedly be among those facing the greatest impact.

As such, the National Association of Specialty Pharmacy (NASP) wrote an open letter to Trump on November 15, 2016, emphasizing the association’s commitment to “working with manufacturers, prescribers and payers to ensure the availability of specialty medications and pharmacy services that are required to ensure optimal patient outcomes.”

It will be vital for specialty stakeholders to advocate for the industry in this new era—where blame might be incorrectly placed on specialty pharmacies for rising drug prices—as specialty drugs are projected to account for nearly half of all pharmaceutical spending by 2020. As NASP points out in their letter to Trump, specialty pharmacies do not set these drug prices.

In fact, specialty pharmacies work closely with their patients to obtain financial assistance that ensures access to needed, often lifesaving medications. With that in mind, our final issue of 2016 highlights several of the exemplary services specialty pharmacies offer that supports patients on a challenging therapy regimen. I urge you to read the latest article by Specialty Pharmacy Times®’ board member Marc O’Connor, COO of Curant Health, who discusses how a personalized treatment program significantly improved adherence rates and outcomes in the sickest of patients fighting HIV.

Among the services performed by specialty pharmacies that helped these patients overcome hurdles to access are assistance with prior authorization processes and copay cards. Also in this issue, SPT board member MaryAnn Dowd, RPh, director of Specialty Pharmacy Trade at Mallinckrodt Pharmaceuticals, discusses the core services that comprise an optimal specialty pharmacy, including the management of appropriate utilization and cost control.

In terms of boots on the ground in the frontlines of health care, specialty pharmacies work the closest with patients in monitoring and maintaining adherence to complex therapies, which is vital to improve outcomes and keep the financial strain on the health care system to a minimum. Innovative programs, such as those outlined in this issue, help illustrate the importance of specialty pharmacies in the patient care paradigm, and highlights the key role pharmacies will play in what could be a dramatic shift in the way the United States pays for health care.

As such, it is vital for specialty stakeholders to stay on top of the latest developments and innovations in the industry, as chronicled in each issue of Specialty Pharmacy Times® and on our daily news website specialtypharmacytimes.com. We would like to wish you and your family a healthy, prosperous, and very happy New Year. 

Thank you for reading.

Mike Hennessy, Sr

Chairman & CEO