4 Things to Consider When Contemplating Specialty Certification

As the specialty pharmacy industry heats up, more pharmacy students may find themselves curious about obtaining specialty certification.

Students who pursue specialty certification can expect to work with medications that treat chronic conditions, require special handling, cost more than $6000 per year, have limited distribution, or are initiated by specialists.

Here are 4 facts pharmacy students should know about the specialty pharmacy industry:

1. Spending for specialty drugs is on the rise.

Today, 37.7% of drug spending is associated with specialty medications. This percentage is expected to grow to 50% by 2018, according to the Express Scripts 2015 Drug Trend Report.¹

Specialty drug spending increased 27.9% in 2015, following a larger 2014 increase of 45.9%, which may have been the result of new hepatitis C therapies. Overall, use of specialty medications rose almost 7% in 2015.¹

In addition, specialty drugs will no doubt gain approvals for more indications in the coming years, new therapies will receive approval, and there may be higher prescribing rates and wider adoption. With advances in specialty medications, however, come high price tags as well.

“Faced with severe financial concerns over the price of specialty medications, state Medicaid agencies and Medicaid health plans continue to implement a diverse set of benefit design, utilization management, and formulary administration techniques to contain utilization and costs for specialty drugs, particularly hepatitis C drugs,” the report stated.

The UnitedHealth Center for Health Reform & Modernization estimates that spending on specialty drugs in 2020 could reach $400 billion.²

2. Patients are increasingly interested in personalized medicine.

Interest in personalized medicine—therapy tailored to an individual patient’s genes, environment, lifestyle, and preferences—is also growing.

Last year, President Barack Obama introduced a precision medicine initiative in his State of the Union address. Obama stated that he would like to see the country lead a new era of medicine with personalized medicine. With rising interest and increased funds devoted to personalized medicine and targeted therapeutics, the specialty field could grow in importance because these targeted drugs may be considered specialty medications.

This means student pharmacists may want to focus on learning more about pharmacogenomics so they can better help their patients find the treatments they need.

3. Specialty pharmacies’ adherence programs can make improve outcomes and lower costs.

The UnitedHealth Center for Health Reform & Modernization noted that specialty pharmacies’ use of coordination and adherence programs shows promise.²

A research group found that specialty pharmacy services led to a total cost savings of around 13% for cancer and transplant services, and improved compliance in patients with cancer, multiple sclerosis, and rheumatoid arthritis.²

Adherence can sometimes be a problem for patients taking specialty drugs because of complex medication regimens, confusion about how to take the medication, and adverse effects. However, these are areas in which pharmacists can help counsel and inform patients to prevent errors and adverse reactions.

4. The relationship between specialty pharmacies and accountable care organizations (ACOs) will likely grow.

In an interview with Specialty Pharmacy Times, Avella Specialty Pharmacy CEO Rebecca M. Shanahan, Esq, noted that ACO incentives align with the services that specialty pharmacies provide. For example, ACOs will look to specialty pharmacies for help with reducing costs and improving patient adherence.

Shanahan said she believes ACOs will welcome knowledgeable partners in specialty pharmacy, and specialty pharmacists will be able to serve as connectors for health care in many disease states.

Fred Eckel, RPh, MS, former editor-in-chief of Pharmacy Times, noted that even community pharmacies will get in the game by altering their dispensing protocols. He suggested that community pharmacists identify patients who need more care and provide services that focus on improving drug therapy outcomes.

References:

1. Express Scripts 2015 drug trend report. Express Scripts website. http://lab.express-scripts.com/lab/drug-trend-report. Published March 2016. Accessed March 29, 2016.

2. UnitedHealth Center for Health Reform & Modernization. The growth of specialty pharmacy: current trends and future opportunities. www.unitedhealthgroup.com/~/media/uhg/pdf/2014/unh-the-growth-of-specialty-pharmacy.ashx. Published April 2014. Access March 29, 2016.