What Defines an Independent Specialty Pharmacy?

CURRENTLY, SPECIALTY PHARMACY IS THE FASTEST-GROWING SECTOR WITHIN THE US DRUG MARKET.1 Since the mid-2000s, the specialty drug trend has surpassed both the overall and traditional drug trend.2

According to a report released in 2015, the specialty drug trend in 2014 was 30.9%, which was significantly higher than that of the traditional drug trend at 6.4%.2 Representing about 1% of all US prescriptions, specialty medications are estimated to contribute up to 44% of the overall drug spend within the next 3 years.2

These substantial changes within the specialty pharmacy market have influenced the increased number and types of specialty pharmacies managing these products (Figure 1). With a variety in the types of pharmacies dispensing specialty products, it can sometimes be difficult to identify key differentiators and specialty capabilities. Independent specialty pharmacies differ in their business model when compared with other pharmacy types.

The term “independence” may be defined as having no payer, pharmacy benefit manager, or other extra-organizational ownership. Having this business model as a key differentiator drives the independent specialty pharmacy to service patients and prescribers for recurring business, considering that no external entities are routing business to the independent pharmacy.

Measurement of success can also act as a key differentiator, as independent specialty pharmacies often reference data from patient and prescriber satisfaction surveys for performance indicators. An evaluation of pharmacy types dispensing specialty products can be challenging, as currently a standard definition of “specialty pharmacy” does not exist; however, many health care organizations have provided insight to defining this term.

The National Association of Specialty Pharmacy, Academy of Managed Care Pharmacy, and the Specialty Pharmacy Association of America have published specialty pharmacy definitions with similarities regarding how specialty pharmaceuticals are distributed and their patient-centric models of care.3

Another term that does not hold a standard definition is “specialty drug” or “specialty medication,” however, just as with the term, “specialty pharmacy,” organizations have tried to define it. Characteristics listed within various definitions may include baseline and continuous monitoring, high cost, restricted distribution models, specialized storage and handling, and the treatment of complex and chronic disease states.3

Without access to universally accepted definitions or practice standards, there are only a few other elements that may be used to further differentiate amongst the various pharmacy types dispensing specialty pharmaceuticals. These include:

Many specialty pharmacies look to various accrediting organizations to provide an external seal of approval on their clinical management programs.

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