Specialty pharmacy refers to distribution channels designed to handle specialty drugs — pharmaceutical therapies that are either high cost,[1][2][3] high complexity[3] and/or high touch.[2] High touch refers to higher degree of complexity in terms of distribution, administration, or patient management which drives up the cost of the drugs. In the early years specialty pharmacy providers attached "high-touch services to their overall price tags" arguing that patients who receive specialty pharmaceuticals "need high levels of ancillary and follow-up care to ensure that the drug spend is not wasted on them."[4] An example of a specialty drug that would only be available through specialty pharmacy is interferon beta-1a (Avonex), a treatment for MS that requires a refrigerated chain of distribution and costs $17,000 a year.[1] Some specialty pharmacies deal in pharmaceuticals that treat complex or rare chronic conditions such as [5]cancer, rheumatoid arthritis, hemophilia, H.I.V.[3] psoriasis,[1] inflammatory bowel disease (IBD)[1] or Hepatitis C.[2][6] "Specialty pharmacies are seen as a reliable distribution channel for expensive drugs, offering patients convenience and lower costs while maximizing insurance reimbursements from those companies that cover the drug. Patients typically pay the same co-payments whether or not their insurers cover the drug."[7] As the market demanded specialization in drug distribution and clinical management of complex therapies, specialized pharma (SP) evolved.[2][8] Specialty pharmacies may handle therapies that are biologics,[1][9][10] and are injectable or infused (although some are oral medications).[2] By 2008 the pharmacy benefit management dominated the specialty pharmacies market having acquired smaller specialty pharmacies. PBMs administer specialty pharmacies in their network and can "negotiate better prices and frequently offer a complete menu of specialty pharmaceuticals and related services to serve as an attractive 'one-stop shop' for health plans and employers."[4]
In the mid 1990s, there were fewer than 30 specialty drugs on the market, but by 2008 that number had increased to 200.[4]
^ abcdeGleason, Alexander G. C.; Starner, C. I.; Ritter, S. T.; Van Houten, H. K.; Gunderson, B. W.; Shah, N. D. (September 2013). "Health plan utilization and costs of specialty drugs within 4 chronic conditions". Academy of Managed Care Pharmacy. 19 (7): 542–8. doi:10.18553/jmcp.2013.19.7.542. PMC 10437312. PMID 23964615.
^ abcde"Specialty Pharmacy Drug List" (PDF). Magellan RX Management. 2015. Retrieved 5 October 2015.
^ abcThomas, Kate; Pollack, Andrew (15 July 2015). "Specialty Pharmacies Proliferate, Along With Questions". New York Times. Sinking Spring, Pa. Retrieved 5 October 2015.
^ abcCite error: The named reference ncbi_2008 was invoked but never defined (see the help page).
^Ingram, David (25 October 2015). "Legal tangle in California may shed light on specialty pharmacies". New York: Reuters. Retrieved 1 November 2015.
^"Diplomat expands hepatitis C specialty services with acquisition of Burman's Specialty Pharmacy". PRNewswire. Flint, Michigan. 19 June 2015. Retrieved 5 October 2015.
^Ornstein, Charles (22 October 2015). "Documents Raise New Questions About Valeant's Pharmacy Relationships in California". ProPublica. Retrieved 1 November 2015.
^Murphy, Chad O. "Specialty Pharmacy Managed Care Strategies" (PDF). Retrieved 24 September 2015.
^"Specialty Drugs Appearing as the Next Wave of Health Care Costs". Workforce. 28 September 2012. Retrieved 5 October 2015.
^Kirchhoff, Suzanne M. (3 August 2015). "Specialty Drugs: Background and Policy Concerns" (PDF). Congressional Research Service. p. 26. Retrieved 27 October 2015.
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