The Growing Role the Specialty Pharmacy Team Plays in Helping Breast Cancer Patients Navigate Treatment

As we recognize Breast Cancer Awareness Month and American Pharmacists Month during the month of October, it is an important time to highlight the growing role the specialty pharmacy team plays in delivering high-quality, coordinated care for patients with breast cancer.^{1, 2}

Breast Cancer Diagnosis’ Impact and Challenges

Breast cancer, one of the most common cancers in US women, is a devastating diagnosis that impacts patients’ mental, physical, social, and financial well-being. Although the median age at the time of a breast cancer diagnosis is 63, this disease impacts women of all ages with 1 in 8 women being diagnosed in their lifetime. For 2026, an estimated 382,640 patients in the US will be diagnosed with breast cancer, and sadly, 42,140 patients could lose their lives to this disease.³

Immediately following diagnosis, patients with breast cancer often find themselves navigating multiple treatment regimens, supportive medications, adverse effects, and transitions that persist throughout the continuum of their care as treatments become more personalized and complex.

As a member of the integrated care team, specialty clinical pharmacists and pharmacy liaisons bring expertise and personalized care that helps support patients through what can be a complicated experience. Their growing, multifaceted roles significantly improve patient experience, adherence, and overall outcomes.⁴

How Specialty Pharmacy Liaisons Manage Barriers to Medication Access and Therapy Continuation

Specialty pharmacy liaisons help patients with breast cancer; oncologists, clinical staff, and the specialty pharmacy work collaboratively to ensure patients begin and stay on their therapy. A 2025 physician survey found that physicians and their staff spend 13 hours per week on prior authorizations (PA).⁵ Specialty pharmacy liaisons integrated into the clinic can relieve the administrative burden on physicians and staff members by taking ownership of the PA. With almost 75% of oncology patients requiring PAs and the growing number of new breast cancer diagnoses each year, the role of the clinical pharmacy liaison will continue to grow in PA support.⁶

A subset of patients, those with early-stage disease who underwent a lumpectomy, were evaluated in a study for adherence, and it was found that less than 30% of these patients were able to maintain adherence to their endocrine therapy over the 5-year treatment period.⁷ Monthly touchpoints with the specialty pharmacy liaison to coordinate medication delivery/pick-up and check in on tolerability of therapy provide patients with an additional layer of support to encourage treatment adherence.

How Specialty Clinical Pharmacists Provide Comprehensive Medication Management

The oncology field, specifically breast cancer, has experienced a number of advancements in recent years.⁸ With the expansion of treatment to include targeted immunotherapies, having a clinical pharmacist on the care team has never been more important. Many of the therapies used to treat breast cancer come with adverse effects such as nausea, pain, and fatigue. Clinical pharmacists provide individualized education on medications, diet and lifestyle modifications, and counseling on long-term hormonal therapies, survivorship care, and lifestyle adjustments.⁹ Similarly to the specialty pharmacy liaison, clinical pharmacists remove administrative burden from providers and clinic staff by serving as an additional clinical resource for patients. In some practices, the clinical pharmacist and oncologist may enter into a collaborative practice agreement, opening the door for further patient support through the ability to prescribe supportive therapies, order laboratory testing, and facilitate follow-up visits.

With advances in breast cancer care, the clinical pharmacist also serves as a resource to the oncology team by watching the drug pipeline for innovative therapies. The pipeline for breast cancer treatment is very active and having a clinical pharmacist in tune with these advancements connects patients to more precise treatments more efficiently. One therapy, giredestrant, is currently under review for approval as an oral selective estrogen receptor degrader to be used in the adjuvant setting for estrogen receptor positive (ER+)/HER2– early breast cancer. Recent approval of camizestrant (Etcamah; AstraZeneca) for patients with ESR1 mutation in HR+/HER2– treats patients with locally advanced or metastatic breast cancer. While these are just 2 examples of pipeline and recently approved therapies, the clinical pharmacist keeps a pulse on upcoming approvals and provides timely education to providers and clinic staff and more efficiently transitions patients to specialized therapies unique to their specific diagnosis.

Improving Medication Adherence and Outcomes

Specialty pharmacy liaisons’ and clinical pharmacists’ roles in reducing barriers and improving medication access and medication management significantly improve patients’ adherence to their oncology medications. Clinical adherence is defined as taking 80% or more prescribed doses, frequently measured as proportion of days covered (PDC).¹⁰

For patients with breast cancer, meeting or exceeding this benchmark offers substantial clinical, psychological, and financial benefits. A 2024 US study of 55,893 US Medicare beneficiaries with stage I–III HR+ breast cancer found that of eligible patients, only 43% started on endocrine therapy within 3 months of being diagnosed.¹¹ Among the women who began endocrine therapy, 77% achieved PDC 80% or more during the first year. The women who did not begin or complete their endocrine therapy initiation experienced a higher rate of breast cancer-related mortality. Armed with this knowledge, liaisons and clinical pharmacists work collaboratively to provide support to these individuals and can increase patient adherence and therefore improve outcomes.

Navigating New Therapies and Precision Medicine in a Changing Legislative Environment

The landscape of oncology treatment is consistently changing and progressing forward with the development and approval of new targeted therapies and precision medicine. With these improvements and new technologies come other changes to the health care structure across the country that can be complex and evolve rapidly.

One example of this is the changes implemented by the Centers for Medicare & Medicaid Services with the Maximum Fair Price (MFP) program. While no breast cancer medications have been included in this program for 2026, looking ahead to the 2027 and 2028 drug selections, there are several oncological therapies included, such as those for breast cancer—palbociclib (Ibrance; Pfizer), ribociclib (Kisqali; Novartis) and abemaciclib (Verzenio; Eli Lilly).¹² This change in negotiated prices and payment structures for the pharmacy may lead to certain pharmacies not being able to fill these medications for patients, therefore reducing availability to treatment.¹³

As a member of the interdisciplinary care team, the specialty clinical pharmacist provides insight for the team on initiatives such as the MFP program and facilitates proactive discussions on the best path forward to ensure continuity of care for these patients.

Receiving a breast cancer diagnosis can be overwhelming; access to the appropriate care should not be. The specialty pharmacy team supports patients with breast cancer directly by ensuring access to therapy, adherence support, side effect management and mitigation, and consistent involvement in evaluating the safety and efficacy of treatment.

Behind the scenes, this team is also supporting patients and providers through monitoring of pipeline therapies for innovative and breakthrough treatments, navigating the ever-changing payor and reimbursement landscape, and serving as a resource to relieve administrative burden. While the month of October is a time to focus on breast cancer awareness and recognize American Pharmacists Month, we also recognize breast cancer care does not stop here. The specialty pharmacy team strives to be an integral part of every patient’s care journey year-round.

References

1. National Breast Cancer Foundation. Breast cancer awareness month. National Breast Cancer Foundation. Updated 2026. Accessed October 23, 2026. https://www.nationalbreastcancer.org/breast-cancer-awareness-month/

2. American Pharmacists Association. American Pharmacists Month. American Pharmacists Association. 2026. Accessed October 23, 2026. https://www.pharmacistsmonth.com/

3. National Breast Cancer Foundation. Breast cancer facts & stats. National Breast Cancer Foundation. Updated June 30, 2026. Accessed October 23, 2026. https://www.nationalbreastcancer.org/breast-cancer-facts/

4. Pei Y, Huang R, Chang F, Hu Y, Versteeg S, Zheng Y. The role of pharmacists in delivering pharmaceutical services to breast cancer patients in clinical and community settings: a scoping review. Pharmacy (Basel). 2025;13(4):97. doi:10.3390/pharmacy13040097

5. American Medical Association. 2025 AMA prior authorization physician survey. American Medical Association; 2025. Accessed October 23, 2026. https://www.ama-assn.org/system/files/prior-authorization-survey.pdf

6. Hematology Advisor. Nearly three in four with cancer experience prior authorizations. Hematology Advisor. October 28, 2025. Accessed October 23, 2026. https://www.hematologyadvisor.com/news/nearly-three-in-four-with-cancer-experience-prior-authorizations/

7. The ASCO post staff. Real-world data indicate lower adherence rates for breast cancer endocrine therapy when radiation therapy is omitted. The ASCO Post. September 30, 2026. Accessed October 23, 2026. https://ascopost.com/news/september-2026/real-world-data-indicate-lower-adherence-rates-for-breast-cancer-endocrine-therapy-when-radiation-therapy-is-omitted/

8. National Cancer Institute. Advances in breast cancer research. National Cancer Institute. Reviewed April 8, 2025. Accessed October 23, 2026. https://www.cancer.gov/types/breast/research

9. Mehmood N, Khan A, Abbas S, et al. Impact of pharmacist-led educational services in promoting breast cancer awareness. BMC Womens Health. 2025;25(1):461. doi:10.1186/s12905-025-04035-0

10. Johnsson A, von Wachenfeldt A. Factors influencing adherence to adjuvant endocrine therapy after breast cancer surgery. Cancer Rep (Hoboken). 2024;7(8):e2160. doi:10.1002/cnr2.2160

11. Qian J, Truong B. Initiation of oral endocrine therapy and survival benefit among women with early-stage breast cancer. J Womens Health (Larchmt). 2024;33(11):1509-1517. doi:10.1089/jwh.2023.0971

12. Centers for Medicare & Medicaid Services. Selected drugs and negotiated prices. Updated 2026. Accessed October 23, 2026. https://www.cms.gov/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/selected-drugs-negotiated-prices

13. Three Axis Advisors. Unpacking the financial impacts of Medicare drug price negotiation: analysis of pharmacy cash flow. National Community Pharmacists Association; January 2025. Accessed October 23, 2026. https://ncpa.org/sites/default/files/2025-01/January2025-NCPASummary-ThreeAxisAdvisors.pdf