Specialty Pharmacy’s Role in the Changing Face of Health Care

2017 promises to be a transformative time in the world of specialty pharmacy.

On the heels of a notable spike in FDA drug approvals in 2014 and 2015, last year proved to be a bit of a disappointment. Just 22 new drugs were cleared by the FDA in 2016—down from 45 the previous year—which represents the lowest number of approvals since 2010.

A potential cause for the plummet, as reported by Reuters, is the challenge of getting new drugs to market that achieve a solid financial return. Pushback from payers and legislators contributes to the rising cost of these treatments, according to the report. While manufacturers claim the high cost of revolutionary new cancer treatments is justifiable to fuel further innovation, patients have raised concerns about the affordability of these treatments.

Despite the slowdown, there were some significant oncology drug therapies brought to market, as noted in this month’s article by Stacey Ness, PharmD, RPh, CSP, MSCS, AAHIVP, and Ruby Mhajan, RPh, of Managed Health Care Associates, Inc on page 35. A report by Bloomberg projects that in 2017, for the first time, oncology drugs will surpass spending on drugs for cardiovascular and metabolic diseases, thus earning a greater share of the $519 billion global pharmaceutical market.

By 2020, it is estimated that Opdivo and Keytruda will combine for approximately $15 billion in annual pharmaceutical spending alone. With a new administration taking control of the White House, significant health care reform has been promised; however, a number of persistent challenges need answers. While there have been multiple solutions suggested to address drug spending—including allowing Medicare to negotiate with pharma to lower prices—any proposal that attempts to define what a drug should cost may underestimate benefits such as overall survival.

Furthermore, with health care continuing to transition to a value-based system, there must also be a concrete method to define a drug’s value when it is effectively used in combination with other oncology treatments. Specialty pharmacy will be a vital cog in the value-based transition, as Specialty Pharmacy Times® board member Marc O’Connor discusses in his latest look at the tectonic shift in health care on page 20.

His article outlines how contracts that base reimbursement on improved patient outcomes, along with drug efficacy, could quickly gain traction. It is clear that specialty pharmacies that effectively advocate enhanced medication therapy management and patient support will be poised to lead the new generation of value-based contracts.

Staying on top of these developments is our mission in this journal and our daily news website, www.SpecialtyPharmacyTimes.com. Follow us online, here in print, and in our e-newsletters (sign up at www.specialtypharmacytimes.com/link/1306) to assure your pharmacy is ready to drive change in the year ahead. 

Thank you for reading.

Mike Hennessy, Sr

Chairman & CEO