Specialty Pharmacy Outpaces Traditional Pharmacy Growth

The COVID-19 pandemic has contributed to specialty pharmacy outpacing traditional pharmacy in non-discounted spending.

Specialty pharmacy growth is outpacing traditional product growth and currently accounts for 49% of total non-discounted spending in the pharmacy space, according to a presentation by Doug Long, vice president of Industry Relations at IQVIA, during the National Association of Specialty Pharmacy (NASP) Annual Meeting and Expo 2020.

Specialty pharmacy spending grew by 10% in June 2020, while traditional pharmacy spending decreased by 0.4%. This trend was seen in both retail and mail-order pharmacies. Specialty spending grew 10.7% in June 2020 while traditional retail spending grew 1%. For mail-order, specialty growth accounted for 80% of the total non-discounted spend. Specialty spend grew 11.4% in June 2020 while traditional products decreased 2%.

“I believe a lot of this has to do with when these shutdowns happened, people weren’t going to hospitals, they weren’t going to go get elective procedures, they weren’t going to office visits, and were relying mostly on telehealth,” Long said, referring to the shutdowns caused by the coronavirus disease 2019 (COVID-19) pandemic.

According to Long, there are 3 areas accounting for 60% of the growth in the United States: immunology, oncology, and diabetes. These 3 areas also accounted for 40% of recent launches. HIV and anticoagulants are also growing areas; however, most of the growth is decelerating. For example, oncology growth has slowed by 7% since the year prior.

Long noted that a lot of changes seen in both the traditional and specialty pharmacy spaces are due to the COVID-19 pandemic. At its peak, COVID-19 was among the leading causes of death in the United States, trailing only heart disease and cancer. One area that has been seriously affected is vaccines, as vaccination sales for 2020 are below pre-COVID-19 levels, according to Long.

The COVID-19 vaccine is expected to be part of a major push that will also have an impact on specialty pharmacy, especially in terms of immunology. COVID-19 vaccine trials are historic in both speed and size, as COVID-19 vaccine studies are between 6 and 20 times larger and 50% faster than traditional phase 3 vaccine studies. However, questions remain surrounding who will get the vaccines first and whether boosters will be needed.

Long said there are still questions as to the correct target, how to successfully perform clinical studies, how to rapidly upscale manufacturing, and how to optimize distribution.

COVID-19 has also been a major supply chain disruptor, according to Long. Patients have increased demand for home delivery and e-scripts, which has increased logistical issues, especially with the disruption to cross-border travel and the commercial airline industry.

Not all the changes made to the specialty industry will be permanent, however, there are some changes that may last. For example, consumer autonomy may very well increase after the pandemic ends and may become more nuanced in the future. One benefit, however, is that testing may play a more central role in the COVID-19 response, which may provide an area for future growth.

“How does this pandemic end? And no matter how it ends supply is key,” Long said. “So, on the social end that’s minimizing, that’s testing, that’s isolation of all vulnerable individuals.”