Specialty Pharmacy Trends: What’s Impacting the Industry Now and in the Future?

Specialty pharmacy is a unique subset of the field of pharmacy. Specialty pharmacy typically encompasses high-cost, high-touch medication for complex diseases. In many cases, patients who need specialty pharmacies are battling cancer or chronic conditions. In looking to the future, we’re sharing some specialty pharmacy trends that anyone in the field should know.

Specialty Pharmacy Sees Substantial Growth

The specialty pharmacy market accounted for significant growth in the industry. According to the Drug Channels Institute 2020 Report, specialty drugs represent 36% of total pharmacy revenue, a new high. The drivers of specialty pharmacy growth include new medications on the market, more chronic condition diagnosis (25-30 million Americans live with a rare disease), and hospital pharmacy expansions. 

As growth remains stable, these specialty pharmacy trends will impact it in various ways. 

Trend One: The Impact of COVID-19 on Specialty Pharmacy

COVID-19 affects every aspect of healthcare. Pharmacists are often the most accessible health care professionals. They have been and continue to play a role in the pandemic. Those patients that rely on specialty pharmacy still need their medications. They may also be more susceptible to severe complications from COVID-19. Because of this, many may not feel comfortable coming to a location, prompting the need for medication delivery and curbside pickup. 

COVID-19 May Impact Patient Volume

A survey of healthcare professionals revealed that 82% reported a decline in patient volume. That’s across the board and could include regular follow-ups for those with chronic diseases and new patients without a diagnosis. Telehealth can bridge the gap here and experiencing rapid acceleration. 

However, fewer patients equal fewer prescriptions, leading to less income. There could be thousands of patients that are sick but aren’t visiting their primary physician. They may also be putting off annual screening. This a real concern for the entire healthcare ecosystem. 

Trend Two: Reimbursement Changes

Reimbursement issues have long been a problem for specialty pharmacy. The NCPA (National Community Pharmacists Association) published a press release earlier this year on the situation. The statement revealed that over 2,000 pharmacies have gone out of business due to poor reimbursements. 

Medicare expansions are putting states in a pinch, and many experts feel this will culminate with reduce reimbursements. There have been conversations about increasing federal matching for states via Congress but no commitment. 

Trend Three: Increased Medication Non-Adherence

Medication non-adherence is not a new specialty pharmacy trend, but the pandemic exasperates it. Nonadherence can account for up to 50% of treatment failures, around 125,000 deaths, and up to 25% of hospitalizations each year in the U.S.

These stats don’t take into account the pandemic. Those patients who take medications every day may have mobility or access issues. Specialty pharmacy, and the entire pharmacy landscape, should take steps to address non-adherence. Using your patient data and data analytics tools, you can identify patients who have missed a refill. Once you’ve isolated these patients, create targeted communication tactics, including calling and sending letters as reminders. 

Trend Four: Drug Shortages

Reports suggest that physicians are excessively prescribing COVID-related medications, although there has been little science to support most of these drugs. It presents the plausibility of drug shortages that you may regularly fill for a patient with autoimmune diseases. Those with lupus take hydroxychloroquine, and it’s been a buzzword around COVID treatment. However, the FDA cautioned its use for this. 

The supply chain disruption is also impacting medication accessibility. The FDA reported over 100 unresolved drug shortages due to this. The reverberations of this may continue for some time. 

Trend Five: Hospital Specialty Pharmacy Growth

Hospital specialty pharmacy is experiencing growth. By expanding their capabilities with specialty products, these hospitals are integrating with providers, infusion centers, and home care. Hospitals, seeing decreases in reimbursements, are adding specialty pharmacy as a new revenue stream. While that may be a driver of the trend, the positive consequence is that continuity of care may improve. 

Trend Six: New Treatments: Possible Pauses, But on Track for More Novel Therapies

Since the world and pharmaceutical companies are hyper-focused on a COVID-19 vaccine, it’s safe to say other research for deriving new treatments for chronic diseases may be on pause. However, this isn’t all bad news, as the development of generic specialty drugs should expand greatly in the next few years. 

The FDA approved over 140 new specialty drugs since 2013, and approximately two-thirds of the 48 novel therapies approved in 2019 were specialty drugs. Additionally, one-time treatments like gene therapies may become more prevalent. Only four have approval now, but there are over 900 clinical trials ongoing.

Specialty Pharmacy Trends: What Does the Future Hold?

These six trends are impacting the industry now and will continue to do so through the next few years. Any specialty pharmacy should have these on their radar and have strategies in place to address them. What are your thoughts on specialty pharmacy in the future? We’d love to hear from those in the field about the challenges you’re facing.