Improving Specialty Pharmacy Speed to Therapy Should be an Industry Priority

The specialty pharmacy ecosystem is complex.It consists of multiple transactions and moving parts that rely on antiquated, redundant, and inefficient communication via paper, phone and fax.

There is a lack of consistency and agreement in the industry as to terminology and definitions, which often leads to multiple approaches to administration of specialty pharmacy programs and benefits. The impacts of these inefficiencies are cumulative, which impedes speed to therapy by days, and sometimes weeks.

Improving this reality was the focus of an April 5, 2016 meeting of key leaders in specialty pharmacy held at the headquarters of the National Council for Prescription Drug Programs (NCPDP). An ANSI-accredited Standards Development Organization, NCPDP creates national standards for the electronic exchange of information related to medications and pharmacy services. Attendees included representatives from specialty pharmacies, electronic health record (EHR) vendors, electronic prescribing infrastructure providers, pharmaceutical manufacturers, health care providers and other industry groups.

Industry leaders looked at drivers for change, the current state of specialty pharmacy, the foundations that have been laid by NCPDP, and additional opportunities to customize and standardize processes. The consensus was that immediate focus should be on measureable, near-term processes that could improve speed to therapy.

Drivers for change
A number of factors are converging that will increase the urgency for changes in the specialty pharmacy ecosystem. They include:
  • Increased demand. Eight of the 10 top highest revenue drugs in 2016 will be specialty. Specialty pharmacy has grown upwards of 20% per year and should account for 40% of all drug spend by 2040.3 According to a report released in 2015, specialty medications represented about 1% of all US prescriptions, whereas they are estimated to contribute up to 44% of the overall drug spend within the next 3 years.4
  • A robust drug pipeline. Two-thirds of new approvals by the FDA are for specialty drugs, not counting the recent introduction of biosimilars.In 2012, there were more than 800 biologics in the research pipeline and new specialty drugs are coming to market with increasing frequency.6
  • Costs. Specialty medications are expensive. They easily cost $2000 per patient per month, with those at the high end running as much as $100,000 to $750,000 annually, or more.The affordability of these drugs is a concern for payers, providers, prescribers, and patients.
  • More patients will need specialty medications. The chronically ill are most likely to need specialty medications, and their number is on the rise. About half of all adults in the United States — 117 million people — had 1 or more chronic health conditions as of 2012, and a quarter of adults had 2 or more. By 2030, the chronically ill population is expected to reach 171 million.These patients will likely create a flood of new specialty prescriptions, which will overburden the ecosystem and result in bigger treatment delays unless changes are made.


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