Specialty Pharmaceuticals: Infertility: A Specialty Pharmacy Success Story

Patients seeking treatment for infertility are a unique group who can benefit greatly from the services of a sensitive and readily-available specialty pharmacist.

Infertility treatment is one of the original “specialty pharmacy” practices. Infertility specialty practices grew out of the advances in infertility treatment in the late 1970s and early 1980s that required control of the patient’s ovulation cycle. The legend drugs prescribed by infertility specialists were needed immediately but were not routinely available at most pharmacies due in part to their high cost. This provided an opportunity for entrepreneurial pharmacists interested in this area. In addition, a few of the drugs needed in the treatment of infertility were not available on the market and required compounding.

At that time, very few pharmacies wanted to do compounding, and the physician had to seek out pharmacies that could provide the needed medications. In addition, some of the infertility physicians were conducting research and had the need for uniquely compounded medications to be used in the clinical trials. As a result, those pharmacies willing to carry the fertility medications and capable of preparing compounds became known to infertility doctors, and these physicians would refer prescriptions directly to that pharmacy.

Another characteristic of these early pharmacies was their incredibly good service. The pharmacies understood the requirements of the patients and the treatment and provided impeccable customer service. Over time, a handful of pharmacies developed a superior reputation for their service to the infertility market, and they grew steadily. Several of them developed an inside and/or outside sales force and began to expand regionally and nationally.

Patients seeking treatment for infertility are a unique group and differ from other specialty patients in several ways. One characteristic is that they are usually very knowledgeable about their condition and their treatment; they have often read and studied extensively about infertility and selected their physician with considerable care. These patients also study the drugs that they will be using and know what drugs they need and precisely when they are to be injected. Women seeking infertility treatment are likely some of the most motivated and adherent patients any pharmacist will ever care for.

At the same time, these patients benefit greatly from the services that are the hallmark of specialty pharmacy. It is imperative that the infertility specialty pharmacy have an infrastructure with clinicians available 24 hours per day, 365 days per year to answer questions that invariably rise during nonbusiness hours. On-call clinicians must have experience with telephonic patient support and must be able to provide assistance with injection techniques. Clinicians must be sensitive to the patient’s sense of urgency and the emotions she is experiencing—due not only to her need for precision on the drug therapy, but also the hormone levels in her system.

Over the past 30 years, there have been great success stories of pharmacies dedicated entirely to infertility and independent from today’s “general” specialty pharmacies. These pharmacies have made an impact on and earned the trust of many thousands of women who could not otherwise conceive. The specialty pharmacies grew and expanded based on their expertise in fertility drugs, their innovation in compounding and support of the medical specialists, and their impeccable service.

Knowledgeable, sensitive, and supportive clinicians dedicated to their practice and patient education were the key to the infertility pharmacy’s success. In many ways, infertility pharmacies paved the way for other innovations in specialty pharmacy through their service excellence and their patient orientation.

Mr. Allinson is chief executive officer and chief clinical officer of Therigy, LLC.