As far back as the late 1970s, when patients were diagnosed with a complex chronic or rare condition and prescribed a specialty medication, specialty pharmacy was not in most retailers’ lexicon.
Yet, there were a handful of retailers who had the foresight to initiate care for these patients from the moment they received a diagnosis and were prescribed specialty medicine. Undeterred by the daunting task of providing in-depth monitoring and patient counseling, as well as reimbursement assistance, many of these retailers nonetheless delved into the specialty market.
The potential benefits of entering this market include the ability to enhance pharmacist-patient relationships to improve health, as well as ratcheting up their bottom line in a market that has experienced substantial growth in recent years.
In fact, although traditional growth in the retail channel is currently outpacing specialty growth with the help of COVID and flu vaccines and has 84% of total spend, Doug Long, IQVIA vice president of industry relations, said May 2021 data showed that specialty spend did increase 3.2% versus traditional, which grew at 4.2%.
Fertility is yet another area that Walgreens specialty concentrates on.
“Within the fertility space, an increasing number of employers in more states are mandating fertility coverage,” Broadus said. “It’s one of the most emotionally trying times for many people. It’s not just for patients experiencing infertility, but also for LGBTQ families as part of their family planning journey, and patients with cancer who need fertility preservation services. We are deeply committed to it.”
CVS Specialty also boasts a range of collaborations that it has with patient advocacy and support groups that are focused on education, awareness, improving access to testing, screening, healthcare services and health equity. These partnerships include the Arthritis Foundation, American Cancer Society, American Heart Association, American Diabetes Association, PAH Foundation, PHAware, National Hemophilia Foundation and the MS Society.
Affordability in Focus
Beyond partnerships and collaborations with advocacy groups and others, helping patients afford specialty medications, which can cost up to $6,000 a year, is yet another crucial responsibility for retailers in the specialty arena, and it requires a knowledgeable staff and the development of cost-saving resources for patients.
Elixir Specialty takes financial assistance for patients to the highest level. “We also find it rewarding that we link 97% of our eligible customer population to financial assistance to ensure they can overcome any financial barriers to therapy that they face,” Gale said.
Thrifty White is not sitting on the sidelines when it comes to helping patients afford their medications. The chain works closely with its manufacturer and payer partners to create programs to support their products/members.
Faulks explained that Thrifty White has joined major health plans, including BlueCross BlueShield Minnesota and North Dakota, and HealthPartners, to make medications available locally for their members.
Offering prior authorization support as a way to mitigate declines in patients starting therapy, adding new medications or staying on therapy also is paramount to success in specialty pharmacy.
Despite all of their efforts to excel at specialty, the pandemic has had a tremendous impact on specialty pharmacies’ ability to provide face-to-face patient care. Still chains rose to the occasion.
“The pandemic definitely taught us to be more flexible in how we deliver care,” Faulks said. “From developing remote models, drive-thru and curbside pickup, our pharmacies remained open and accessible to patients throughout the pandemic. Even in the early days when many clinics closed, our specialty patients could still visit the pharmacy, get trained on their medication or get an injection from our pharmacist. This access to care was a huge win and a great example of how important the community pharmacy setting is.”
Walgreens also served patients when shut downs were in place. “All in all, we stayed open and provided support to patients throughout the pandemic, as well as during various natural disasters. Because we’re locally based, we’re able to support our patients through it all,” Broadus said.
CVS Specialty also remained focused on ensuring that members had access to specialty medications amid the pandemic. “We were prepared with digital tools, engaged patients, connected clinicians, consistent messaging across channels and ready access via digital or phone to ensure patients had access to expert clinical staff to answer questions and support healthcare needs,” Shah said.