The Ins and Outs of Specialty Pharmacy

Formerly an obscure subsection of the pharmacy sector, specialty pharmacy is now an area that most health care professionals recognize. Specialty products now dominate the drug pipeline, having gained more approvals than traditional medications since 2010. Specialty medications are the major reason for increased drug spending, which is anticipated to hit $400 billion by 2020. 
 
The National Association of Specialty Pharmacy (NASP) was founded in 2012 to support the rapidly growing specialty pharmacy industry. Without an intimate knowledge of the industry, some may ask, “What makes these specialty drugs so special?” Drugs are classified as specialty products most often due to the cost and complexity of the therapy.  

NASP defines specialty pharmacy as “a state-licensed pharmacy that solely or largely provides only medications for people with serious health conditions requiring complex therapies. These include conditions such as cancer, hepatitis C, rheumatoid arthritis, HIV/AIDS, multiple sclerosis, cystic fibrosis, organ transplantation, human growth hormone deficiencies, hemophilia, and other bleeding disorders. In addition to being state-licensed and regulated, specialty pharmacies should be accredited by independent third parties, such as URAC, the Accreditation Commission for Health Care, the Center for Pharmacy Practice Accreditation, or the Joint Commission, in order to ensure consistent quality of care.”

Specialty pharmacies connect patients who are severely ill with the medications that are prescribed for their conditions, provide the patient care services that are required for these medications, and support patients who are facing reimbursement challenges for these highly needed but also frequently costly medications.

Specialty medications have a complex profile that require intensive patient management and, in some cases, special handling. Although some are taken orally, many of these medications need to be injected or infused, at times in a physician’s office or hospital.

Specialty pharmacies provide services that include training in how to use these medications, comprehensive treatment assessment, patient monitoring, and frequent communication with caregivers and the patient’s physician or other health care providers.

The expert services that specialty pharmacies provide drive adherence and persistency, proper management of medication dosing and adverse effects, and ensure appropriate medication use. The specialty pharmacy patient-centric model is designed to provide a comprehensive and coordinated model of care for patients with chronic illnesses and complex medical conditions, achieve superior clinical and economic outcomes, and expedite patient access to care.”

The American Pharmacists Association describes specialty medications as having some or all of the following key characteristics:
  • Treatment of complex, chronic, and/or rare conditions.
  • High cost, often exceeding $10,000, with some costing more than $100,000 annually.
  • Availability through exclusive, restricted, or limited distribution.
  • Special storage, handling, and/or administration requirements.
  • Ongoing monitoring for safety and/or efficacy.
  • Risk evaluation mitigation strategy. 


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