Rebecca Shanahan, Avella’s CEO and president of the National Association of Specialty Pharmacy joined other nationally prominent thoughts leaders in healthcare at the 14th Annual MHA Business Summit. Ms. Shanahan offered a perspective on specialty pharmacy, contributing to a rich program that included an outlook for healthcare reform, pharmaceutical market overview, value-based payments, clinical therapy insights, payor trends, how to navigate complex markets and more. She revealed industry insights, trends and predictions, spotlighting the central role of pharmacy, among drug wholesalers, manufacturers, pharmacy benefit managers and payers--and the deep relationships that specialty pharmacy forges within this system on behalf of each patient.
See the 2017 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers for greater detail.
The Specialty Landscape
Specialty drug approvals by the FDA outpace traditional drug approvals for the first time since 2010, with medications to treat cancers and orphan/rare diseases leading the way. The technical development drug pipeline is also heavily weighted toward expensive specialty therapies; of the 630-plus distinct research programs in Phase II or later research, 37% are for specialty market medicines, according to IMS Health.
Spending in this highly visible sector continues to grow, with specialty pharmacy anticipated by Pembroke Consulting to double from $98 million in 2015 to $212 million by 2020. Pricing pressure for high-profile medications builds from negative media coverage, elected officials and consumers with a drive for major change in reimbursement models as the Affordable Care Act is being redrawn. At the same time, the industry is consolidating with emphasis on acquisitions, mergers of equals and other strategic partnerships looking to leverage highly valued specialty pharmacy services. See the 2017 overview of specialty pharmacy mergers/acquisition activity.
Toward the Trifecta of Improved Quality, Reduced Costs and Higher Patient Satisfaction
Specialty pharmacies offer all-hours access to clinical pharmacists for patients, advanced data insights, ongoing coordination at the point of care and technological tools to help patients remember to take their medication(s), otherwise referred to as adherence, and minimize side effects.
Medication non-adherence is a serious, widespread issue that impacts clinical outcomes and contributes to rising healthcare costs. In fact, 20-30 percent of prescriptions written are never filled by patients and around half of all medications for chronic conditions are not taken as prescribed. As a result of this non-adherence, patients may experience preventable complications, disease progression, acute events and hospitalizations. The No. 1 reason for missing doses? Forgetfulness. Text message programs, mobile apps and the growing use of telehealth are making inroads in this arena. Avella’s text message program showed an initial 29% increase in adherence for the low-compliant cohort and Avella’s pilot with AdhereTech “smart bottles” demonstrated 22% higher compliance than the Control group.
Web-based provider portals enable tracking of patient adherence and prescribing activity, fostering collaboration between pharmacist and physician. Greater connectivity between specialty pharmacy systems and provider electronic medical records offers next-level data.
On the Specialty Pharmacy Horizon
- Specialty pharmacy’s role in value-based care models will continue to grow.
- Financial pressures will increase with more merger/acquisition activity, tight formulary management and increased prior authorization requirements
- Manufacturers are in the spotlight with heightened scrutiny on drug pricing and manufacturer-sponsored copay programs
- Specialty pharmacy’s technological tools will continue to expand as the adoption of wearables and mobile technology for patients skyrockets.
Stay tuned for more industry insights at Asembia 2017, the largest U.S. conference for specialty pharmacy, kicks off April 30, featuring Rebecca Shanahan and Eric Sredzinski, Pharm.D., EVP, Clinical Affairs & Quality Assurance.
