The Ins and Outs of Specialty Pharmacy

Although the origins of specialty pharmacy began with oral transplant and HIV therapies, most people associate medications falling into this category as injectable or infusion products. Most recently, oral oncolytics have dominated the industry with respect to new drug launches.   

Specialty pharmacies are designed to manage patients with these disease states.  Along with a disease state knowledge-base, these pharmacies have tools to complete the required handling, storage, and distribution of complex medications that require high-touch patient management.

The American Pharmacists Association lists some of the services offered by specialty pharmacies that go beyond the typical retail level:
  • 24-hour access to pharmacists
  • adherence management
  • benefits investigation
  • communication and follow-up with the physician
  • dispensing of specialty pharmaceuticals and shipping coordination
  • enrollment in patient assistance programs
  • financial assistance
  • patient education and medication adverse effect counseling
  • patient monitoring for safety and efficacy
  • payer and/or manufacturer reporting
  • proactive patient outreach for prescription refill and renewal
  • prior authorization assistance
Several specialty medications belong to an exclusive or limited distribution network.   This model restricts the distribution channel for a pharmaceutical product to one (exclusive) or a few (limited distribution) network of pharmacies. There are several reasons why a pharmaceutical manufacturer may choose this type of distribution model. 
First, it can ensure safe distribution of high-risk medications to small patient populations.  Second, it allows the manufacturer to have added control over the patient’s experience with their product. 
Pharmacies who agree to the limited distribution network make promises to follow specific procedures outlined by the manufacturer to aid in patient safety, adherence, and outcomes. Examples of this may include how often outreach is made for counseling and/or order scheduling, patient education provided by the pharmacy, the type of information collected from the patient and/or prescriber, or financial assistance programs offered.   
This information may be useful for manufacturers to evaluate the collected data for trends, which is made possible by working with a smaller number of pharmacies. Although specialty pharmacy medications are the minority of available drug products, they are the most costly and complex. 
Specialty pharmacies have the required infrastructure to manage patients and their medications needed to treat these complex disease states.
Works Cited
Dimensions: Specialty Management Solutions. Published May 16, 2016. Accessed August 2, 2018. 
Emerging Trends in the Specialty Drug Industry. Drug Topics. Accessed August 2, 2018. 
NASP Definitions of Specialty Pharmacy and Specialty Medications. Published February 24, 2016. Accessed August 2, 2018. 
Specialty pharmacy: A unique and growing industry. Home. Accessed August 2, 2018.
About the Author
Michelle Byrne
 earned her Doctor of Pharmacy degree from Duquesne University and is currently enrolled in the Master of Science in Pharmacy Business Administration (MSPBA) program at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines.  Michelle has worked in the specialty pharmacy industry for the past 9 years, starting as a clinical pharmacist and working in leadership roles within her organization. Michelle’s current role is Pharmacy Manager, Quality & Regulatory and Pharmacist-in-Charge for her site within the Specialty Operations division of her organization.

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