What is a Specialty Pharmacy?

An introduction to the specialty pharmacy industry by Therigy

Retail Pharmacy vs. Specialty Pharmacy

You might be familiar with retail pharmacies. These are establishments where you can purchase over-the-counter medications such as pain relief, allergy care, and cough suppressants. You can also pick up your usual prescriptions from retail pharmacies. The pharmacists here provide general healthcare advice to the public. Most retail pharmacies sell many other items and can be seen as stores of convenience for most of your needs. 

Specialty pharmacies, on the other hand, deal with specific specialty medications that cannot be found in retail pharmacies. These pharmacies are targeted on high cost products that are used to treat complex specific disease states including chronic and rare conditions. Specialty pharmacies not only dispense oral, injectable, and biologic agents, but provide remote patient care. Employees at specialty pharmacies fulfill completely different duties using a unique skill-set to navigate the complexities between insurance, providers, and the patient. They are patient advocates, helping with co-pay assistance, medication management and therapy compliance, all to improve the patient's health.  Communications with patients can occur a variety of ways including phone calls, mobile-enabled patient assessments, and/or patient pickup. 

 

What are Specialty Medications?

Specialty medications are oral, injectable, inhaled or infused medications characterized as high cost drugs. These medications are large molecules and complex proteins that undergo a biotech process to create. Non-specialty drugs are simpler to create using a chemical process and typically pressed into a pill or filled in a capsule. Specialty medications are more complex to administer and handle, often necessitating special shipping and storage requirements such as temperature control. these medications require advanced patient support needs usually due to severe side effects that can impact adherence. They have complex payor coverage requirements under medical or pharmacy benefits. Specialty medications are used in treatment of many different therapeutic categories.

Some common specialty therapeutic categories that you've probably heard of are:

  • Blood disorders
  • Heptatitis B & C
  • HIV/AIDS
  • Infertility
  • Multiple Sclerosis
  • Oncology (Cancers)
  • Rheumatoid Arthritis

Traits of a Specialty Pharmacy

  • Provides high touch care to specialty patients including prescription fulfillment, preauthorization and financial assistance, medication and therapy education, counseling, adherence improvement strategies, refill reminders, and monitoring therapy outcomes 
  • Responsible for purchasing and handling of specialty medications
  • Assists physicians and clinic staff with the medication acquisition process including benefits investigation, prior authorizations, and administration training
  • Provides quick turn-around time for fulfillment of new patient referrals
  • Coordinates with care providers such as nurses and clinics for injections and infusions
  • Provides quality controls for medication handling and shipment
  • Patient Care Coordinators have strong acumen in navigating insurance coverage criteria and patients' benefit design
  • Coordinate care with the patient's prescriber and other healthcare workers to ensure seamless care and monitoring
  • Clinicians have an in-depth knowledge of specialty diseases and medications
Iso_Color

Specialty Pharmacy Stakeholder Benefits

How does a specialty pharmacy support patients, providers, pharma, and payors?

sp icon 1-2

Patients

Specialty pharmacies...
  • will educate patients on medication and therapy to decrease stress associated with the diagnosis
  • deliver medication to patients when it is needed 
  • are therapy experts usually available 24 hours/day for patients' questions/concerns regarding patient therapy
  • help patients with financial assistance and/or foundations available to suit their needs

sp icon 2-4

Providers 

Specialty pharmacies....
  • provide doctors visibility into their patients' status
  • handle the investigation of the patients' health plan coverage
  • follow up with patients and document outcomes and adherence to share with the provider
sp icon 3-2

Pharma

Specialty pharmacies...
  • help to improve medication compliance and therapy success
  • help prevent disruption in patients' therapy
  • help to reduce medication errors & drug related problems
sp icon 4-2

Payors

Specialty pharmacies....
  • help with population health improvement
  • reduce unnecessary fulfillment costs
  • are usually the lowest cost of care setting
  • help with risk avoidance

How does Therigy help specialty pharmacies?

Therigy's specialty therapy management platform, TherigySTM, is integrated with select dispensing systems and EHR platforms, creating a scalable and automated clinical management tool to help specialty pharmacies manage their patients and grow their business.

 

SP_Journey_Infographic_4

Interested in Working in the Specialty Pharmacy industry?

Therigy is hiring! Check out our available careers and see how you can become part of the Therigy family below.

Careers at Therigy

Ready to get in touch?

 

Contact us to see how our expertise can assist your pharmacy, health system, or other business.

Contact Us