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Specialty Pharmacy and the Future of Healthcare

The 10th Annual Armada Specialty Pharmacy Summit was held in Las Vegas May 5th through the 9th.  It was a very informative meeting with Michael J Fox as the keynote speaker.  The big topic was the growth expectation of specialty pharmacy over the next five years and how we, as specialty pharmacies, can work together with payors to control costs while providing useful data to the payors and the manufacturers, as well as monitor patient adherence.

One of the speakers, Debbie Stern, gave a great talk on the data that is provided in the EMD Serono Specialty Digest 10th Edition.  You can receive a copy of this information by visiting their website and registering.  Some of the highlights included the less than 50% satisfaction rate that payors have with clinical and utilization management services as well as reporting services by specialty pharmacies.  We have to improve this data as an industry.  Two companies control almost two thirds of this market and many others make up the other third.

As a reminder, the definition of a specialty pharmacy is noted below as adopted by Specialty Pharmacy Association of America (SPAARX) in April of 2013.  Although there is now a specific definition, payors define specialty based on various factors and each one can have a little different perspective.  The most agreed upon criteria to be categorized as specialty is cost.  85% of the plans ranked cost as the number one factor followed by treats chronic diseases (81%), orphan drugs (74%), requires special handling, storage and distribution (73%) and it continues from there. (See EMD Serono data)

Specialty Pharmacy is a unique category of professional pharmacy practice that incorporates a comprehensive and coordinated model of care for patients with chronic illnesses and complex medical conditions. Specialty pharmacies dispense / distribute FDA approved medications, coupled with integrated therapy management services, patient education and counseling. Integrated standard-of-care services expedite start of therapy, drive adherence, compliance & persistence, monitor and manage patient dosing, and drug effectiveness & appropriateness. This patient-centric model is organized to provide reliable access to typically high-cost, injectable / infusible / oral and other hard-to-manage therapies within a collaborative, quality-driven framework designed to achieve superior clinical, humanistic, and economic outcomes.

These medications are certainly a big part of the future of healthcare in many ways.  Hopefully, we will find ways for people to access these medications in a cost effective manner.