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Patients using specialty drugs have complex conditions and care needs that require extensive support and coordination. At the same time, the costs related and the overall access a patient has to specialty pharmacy is a growing challenges in today's world. Total spending on specialty drugs was about $87 billion in the US in 2012 and is expected to quadruple to about $400 billion by the year 2020.
Regardless of the pharmacy practice area, one must have come across the terms of specialty pharmacy and specialty pharmaceuticals. With a rich drug pipeline and innovative programs like specialty-at-retail, specialty pharmacy permeates many areas of the industry. So what exactly is the future of this industry? Here we discuss some of the latest trends in the field of specialty pharmacy.
Specialty pharmacy which once occupied a very small place in the market, now forms a huge part of the pharmacy industry. Some of the major specialty pharmacy trends for 2016 and beyond include:
The major trend which is catching all attention is the increased amount of spending being devoted towards specialty pharmacy. With so much emphasis on the cost of healthcare in the US today, the expenditure on drugs is gaining increased attention from those who are paying ever-increasing bills.
In the next 5 years, more than $100 billion will be spent on developing generic specialty drugs. Historically there have been a few generic opportunities when it comes to specialty pharma, but along with the upcoming 'wave' we expect several new and substantial generic entries to arrive as an alternative to significant specialty drugs. Anticipation of these new generic drugs is already having a significant impact on the strategies of many pharmaceutical manufacturers.
Speaking of development, today the pharmacy pipeline is bulging with specialty pharmacy products. These drugs are closely monitored and there are more than 600 specialty products in the current pipeline. These drugs cover many categories and oncology is particularly well represented, accounting for nearly half of all drugs.
The next major trend in specialty pharma is the move from "shotgun" medicine to targeted therapies. Within the specialty pipeline we see that nearly 70 percent of the drugs have an identified biomarker associated with them. Not all of these markers have been turned into meaningful tests yet. However it is a solid bet that we will see personalized medicine grow on the drug discovery side as well as the drug prescribing and managed care side.
This trend is highly dependent on the impact of legislative and regulatory activity. Healthcare reforms will swell the ranks of many payers. One of the most pronounced impacts will be on Medicaid programs, many of which are already struggling to make ends meet for their existing patients. As they struggle to absorb the growing numbers of patients resulting from the new coverage, the ensuing budget cuts and the declining reimbursement rates will pose huge financial challenges for those attempting to provide care to patients.
This is in reference to the programs that target patients with commercial coverage. The growth in the number of these programs is staggering and will continue to be so in the near future. There are signs that we may have finally reached the tipping point where payers and PBMs are determined to find ways to control these programs.
Pharmacists play a vital role in their organizations by leveraging technology to provide patient care services and medication therapy management (MTM). MTM can improve medication adherence and dosage outcomes amongst patients suffering from chronic diseases, thus cutting costs and improving the quality of care and patient safety. As advanced MTM becomes more widespread, various MTM activities and interventions will require information obtained through health information exchanges as well.
Prescriptions are rapidly increasing for specialty medications, which are high cost, complex therapies that require special handling, administration, and monitoring. Specialty medicines account for less than 1% of prescriptions, but more than 25% of prescription spending, a number which is expected to reach 50% by 2018.
Real-time pharmacy benefits will not be widely available in the near future, although it is being pilot tested. There are two models: one using the NCPDP telecommunication (pharmacy claim) standard and the other using NCPDP standard. Both hold promise to improve accuracy and bring clarity to the group-level formulary and benefit paradigm that is in use today.
The traditional pharmacy business is under siege as it faces challenges from healthcare reform and competition. As community pharmacies scramble to survive, the specialty pharmacy model offers a lucrative opportunity for growth. One needs to understand and prepare for a wide variety of challenges on many different fronts, ranging from acceleration to marketing. That's the message from community pharmacists who are urging others to take advantage of the growth in specialty pharmacy.
Although this category of specialty drugs has historically focused on injectable and infused formulations, a significant number of specialty medications in oral dosage forms have entered the market recently. The trend is only expected to continue, especially among oral oncolytics. Due to the complexities associated with specialty pharmaceuticals, patients receiving these medications require a significant degree of continuous patient education, ongoing monitoring, and medication management by well-qualified and skilled specialty pharmacy staff.
Specialty pharmacy has grown from its niche beginnings to a burgeoning, multi-million dollar industry. Pharmacists, regardless of their area of practice, should understand the place of specialty pharmacy within the industry, even though the field may be difficult to define. Collaborations between specialty pharmacies, retail settings, hospitals, and manufacturers are becoming increasingly commonplace. These collaborations can enhance patient access to specialty pharmaceuticals and the high-touch services a specialty pharmacy can provide, thereby improving patient care.
We at Flatworld Solutions have been providing cost-effective pharmacy business services for over a decade now to clients around the world. If you have any such requirement, feel free to get in touch with us.