Assessing Specialty Pharmaceutical Trends Reshaping the Field for the Future

Pharmacy Times interviewed Doug Long, vice president, Industry Relations, IQVIA, on his presentation at the Asembia Summit 2022 titled The Specialty Pharmacy Industry Update and Outlook.

Question: What are some key trends of note reshaping specialty drug channels?

Doug Long: Well, the first thing is that it looks as though that, for the first time in history, specialty pharmaceuticals have a higher dollar share than traditional. So that's the first one, second one is that specialty did fairly well during COVID-19. It looks like it's recovering. The third thing is that we're starting to see the biosimilar way pick up and next year may be big when you see as many as 10 biosimilars on [adalimumab (Humira; AbbVie Inc)].

Question: Has there been any recently published research that may have a significant impact on the direction of the specialty pharmacy industry?

Doug Long: Nothing that I've seen published recently. I think one of the issues is the expense of specialty drugs.

In one of the meetings today, the affordability comes up, not only for the patients, but also for the employers. You have something like 5% of the patient population consuming 50% of the health care costs for that employer, and now with cell and gene therapies, it’s only going to get more complicated.

Question: Have there been any developments in the specialty pharmacy market that may impact the role of the pharmacist on the health care team?

Doug Long: Well, I think one of the things that everybody's struggling with right now is staffing, whether it's retail pharmacy or specialty pharmacists—not only the pharmacist, but the technicians. That's a very real issue, which is exacerbated by COVID-19.

At least on the retail side, that's going to lead to more central fill, because you’ve got to free up the pharmacists to do what they need to do, and not necessarily counting out pills.

Question: How might further adoption of biosimilars impact payer coverage, and what are the implications of this?

Doug Long: Well, we've seen that this next 4-year period, there'll be $100 million of potential savings of biosimilars. So that's certainly going to ease health care cost concerns.

Similar to previous years of generics, we're kind of running out of steam with generics, so we're going to need a vibrant biosimilar marketplace. The question is who's going to be the influencer of that.

For hospital products, biosimilars are very different than the pharmaceutical-based products. Then, of course, it depends on the doctor and what the net cost is, what the net profit is, and all of that. So it's going to be quite dynamic and interesting.

Question: What is the role of the pharmacist in promoting financially accessible options for patients in the specialty pharmacy space?

Doug Long: Well, I mean, it's always been a big role. I think it's going to be a bigger role going into the future because you have people that have a hard time getting on therapy, through step edits and pre-authorizations and things of that sort. So it's got to be a lot of hand holding to get that get them on medication that's going to work for them.

Question: What are some trends in the specialty pharmacy marketplace that are allowing for greater financial accessibility while maintaining drug efficacy and safety for patients?

Doug Long: Well, I think the big one is obviously going to be biosimilars. You're going to see biosimilars on 2 of the biggest products, [adalimumab] and [ustekinumab (Stelara; Janssen Biotech, Inc)], in the next 5 years, so that will really put a dent into the autoimmune space. We've seen a big uptake in some of the cancer oncology biosimilars. So it’s finally reached its stride, I think.

Question: In your view, what is the outlook for pharmacists in the specialty pharmacy space this year?

Doug Long: Well, I think everybody's trying to find pharmacists. There that might become more signing bonuses and things of that sort.

But I guess the thing is, you got to find a place you're going to be happy with that matches up with what they want out of their current pharmacy career, in terms of patient interaction and things of that sort.