Beyond the Dose: Past, Present and Future of Specialty Pharmacy

There are many challenges across healthcare right now, but let's talk about one of the ways we are getting it right: specialty pharmacy.

Specialty pharmacy has reshaped the healthcare landscape over the past few decades. In fact, it accounts for a mere 3% of prescription volume but a staggering 60% of drug spending in the U.S.,¹ highlighting the power of innovation and precision medicine.

Transformative therapies: Real lives, real impact

Specialty drugs are not just about numbers; they are about real patients with real needs.

In 1990, a patient diagnosed with a condition like cystic fibrosis (CF) had few, if any, options. Over the years, the incremental growth of specialty medicine has led to breakthroughs in CF and many other conditions.

Fast forward to today - there are over 400 specialty drugs transforming care across more than 40 disease states.

This isn't just progress; it's a revolution fueled by scientific innovations and an unwavering commitment to making the impossible, possible.

For instance, advancements in HIV treatment have turned what was once considered a death sentence into a manageable condition. Patients can now take a single pill daily or receive an injection every two months to live symptom-free and prevent transmission.

Similarly, gene therapies that teach the liver to produce clotting factors for hemophilia exemplify the life-changing potential of specialty drugs.

The business side of pharmacy

Innovation requires investment, and specialty medications come with a hefty price tag. But when the outcome is the ability to manage chronic illnesses or save lives, we can all agree it's worth the time and money.

With the specialty drug pipeline projected to grow by 8% through 2025,² and up to two-thirds of new drug launches expected to be specialty drugs in the next five years,¹ the industry's impact is only set to expand.

Despite their value, the system surrounding specialty drugs remains a challenge. Patients, providers, and manufacturers must navigate a complex web of policies, including prior authorizations, step therapy, and patient assistance programs. Specialty pharmacies play a pivotal role in managing these challenges while focusing on the core mission of improving patient outcomes.

The path forward: Balancing cost and collaboration

Each participant in the supply chain has a part to play in the future of pharmacy, and each faces unique obstacles. As more complex therapies enter the marketplace, the requirements from stakeholders continue to increase, directly impacting specialty pharmacies.

At Inovalon, we are committed to providing specialty pharmacy software that empowers our customers to address these complexities. By connecting stakeholders and streamlining processes, we are helping to drive the specialty pharmacy industry forward.

Watch my discussion with Michael Einodshofer, an industry leader who brings perspectives from multiple specialty pharmacies and a large health plan, about how innovation, collaboration, and technology are not just addressing today's challenges but shaping a brighter, healthier tomorrow for us all.

¹ "Specialty drug growth is here to stay," CarelonRX, January 24, 2024, https://www.carelonrx.com/perspectives/specialty-drug-growth

² "Three Specialty Drug Trends to Prepare for: Biosimilars, Gene and Cell Therapies, Cancer Drugs," Harold Carter, PharmD, Evernorth, accessed December 2024, https://www.evernorth.com/articles/specialty-drug-pipeline-biosimilars-and-more

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