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What Makes Specialty Pharmacy Special

I recently attended the National Association of Specialty Pharmacy (NASP) annual conference. I had to see for myself what is driving all the energy we are hearing about in the niche pharmacy segment known as specialty pharmacy. This market addresses the expensive and difficult-to-access medications that are prescribed for complex disease states like rheumatoid arthritis, hepatitis C, HIV, MS, and others.

In recent conversations with pharmacy leaders from around the country, KLAS has heard providers describe specialty pharmacy as "critically important" and "a huge focus." But most are searching for solutions and want to understand the available technologies. As an example of the influence of specialty pharmacy, consider the recent release of the drug SOVALDI.

Patients suffering from hepatitis C now have a long-awaited viable cure available. But treatment costs can exceed $84,000, making payers reluctant to authorize the drug. In just six months since its release, SOVALDI has already become the fourth-highest revenue-producing drug in the United States for 2014. Since the cost is unlikely to decrease in the foreseeable future, payers are seeking tighter control of the distribution of the drug.

With drugs like SOVALDI, patient medication adherence and pharmacist counseling become critical to ensuring successful treatment adoption. While the potential for high revenues will continue to attract provider organizations into the specialty pharmacy space, the identification and measurement of successful clinical outcomes is merely a wish and remains undefined at this point.

Specialty pharmacy IT vendors claim that the transfer of patient data from EMRs to pharmacy systems exists in limited deployment today but readily admit that the reverse flow of patient information is not yet happening. This data flow back to the EMR will be key for today's health systems as they continue to move toward a patient-population focus and value-based care. Measurement of patient medication adherence (through both provider and patient efforts) should help determine specialty drug ROI and begin to more readily define the impact of specialty pharmacy meds.

Pharmacists seem poised to evolve into a more intimate advisory role with patients and to have a deeper impact on clinical outcomes.

In the coming weeks KLAS will be asking providers about their current capabilities and future plans regarding specialty pharmacy. Drop me a note if you have any insights or questions about this soon-to-be measured KLAS segment.