Specialty Pharmacy: Scrambling for a Piece of the "Pie"

Specialty medications account for about 33% of annual spending on drugs in the United States, up from 19% in 2004 and heading toward 50% in the next 10 years, according to IMS Health. With this trend has come a corresponding boom in specialty pharmacy, which is estimated to have grown from $20 billion in sales in 2005 to $78 billion in 2014. To get a piece of this pie, insurers, pharmacy benefit managers, hospitals, and retail pharmacies are scrambling to start or acquire specialty pharmacies or expand the ones they have.

Retail pharmacies are doing the following to compete for the business of dispensing specialty drugs¹:

• Using retail locations
• Building internal specialty pharmacy services
• Outsourcing specialty pharmacy services
• Acquiring a specialty pharmacy
• Joining a specialty network services alliance

The specialty boom isn’t just about dispensing medications, however. It’s about providing a higher level of service to which patients are responding. Specialty pharmacies are known for helping patients manage complex, chronic conditions by assigning a health care team—an enrollment specialist, a pharmacist, a patient care coordinator, and a billing coordinator—to develop an individualized plan for a patient’s clinical care, insurance, and financial administrative assistance needs.

It’s no surprise that specialty services in retail pharmacy are taking hold. For example, the CVS/caremark Specialty Services website offers the following promise from the pharmacist to the patient: “As soon as you receive services, you will have your own individualized care system in place. A system that guides you every step of the way, answers your questions, and provides you with the best possible service and medication.”

The specialty pharmacy business is driven by the development and sale of treatments for diseases and conditions about which all pharmacists should be educated. Although a retail pharmacist may not dispense specialty medications to patients, understanding their specialty-related disease or condition can optimize patient counseling in terms of how retail medications affect these individuals and interact with their specialty medications. So we offer this Specialty Pharmacy issue to help you stay up-to-date on topics such as hepatitis C virus, ambulatory infusion therapy, and HIV counseling, which may affect patients you see every day in your retail pharmacy.

To help you stay abreast of the fast-paced changes in specialty pharmacy and the opportunities it is presenting, we’ll continue to keep a close eye on it and highlight its increasing influence on retail pharmacy. The growing specialty pharmacy pie is an immense opportunity—not only for corporations but also for individual pharmacists in all areas of practice.

Thank you for reading!

Mike Hennessy

Chairman and CEO

Reference

1. Fein AJ. Employers See Differences Between Specialty and Retail Pharmacy...For Now. Drug Channels website. www.drugchannels.net/2015/05/employers-see-differences-between.html. Accessed August 15, 2015.