Specialty pharmacy a rapidly-emerging area of practice

Long seen as a somewhat mysterious and complex offshoot of community pharmacy, specialty pharmacies help patients access, obtain coverage for, appropriately use, and continue to manage high-cost biologic medicines for their rare and complex conditions.Specialty pharmacy practice is still a resource-, investment- and labour-intensive area of pharmacy practice, however a number of emerging factors are combining to make aspects of this practice more accessible to community pharmacies who wish to manage specialty prescriptions for their patients. These trends include:• the availability of technologies to help patients and pharmacists better manage complex drug regimes; • the emergence of more affordable, stable and patient-friendly oral format biologics;• increasing pharmacist scope of practice to provide patient care services that are more often being reimbursed by government drug plans • a growing interest among pharmacists to specialize their practice by disease state or condition. Patient-driven marketThese and other issues were highlighted in the Specialty Pharmacy Summit presented by Neighbourhood Pharmacy Association of Canada on November 28-29. Attendees at the summit learned about drug launch, sales and pricing trends impacting the specialty market from Mark Omoto of IQVIA Canada. Among the interesting trends to watch: Specialty pharmaceuticals now comprise 50% of the Canadian pharmaceutical market in sales; there are currently more specialty drugs than commercial drugs in the notice of compliance stage; the rate of approvals by government payers for biosimilars is accelerating and will continue to speed up. Omoto also noted that patients are driving their own care in a number of the leading specialty drugs— for example, 54% of patients starting Wegovy do so on their own initiative (hearing about the drug via social media, advertising or friends or family) and pay for it out of their own pockets. Looking to the near future, Omoto noted that the metabolic category of specialty drugs will very soon be the world’s largest, followed by oncology and then immunology products. Technology an enablerTechnology will also be key to the democratization of specialty pharmaceuticals, according to panelists representing Canada’s leading medication management technology firms. The industry is working towards developing what will at some point be the Fitbit or Apple Watch of medication management, said Jeff Wandzura, CEO of Keep Labs, an in-home medication adherence system. Ramy El-Kholi, COO of OKRx noted that new in-pharmacy technology must enable the pharmacist to meet users where they are and in the format they prefer...whether they are comfortable communicating via text, email, fax, phone or printed document. Personalizing the care, service and documentation for all users is essential, agreed Auxita executive VP Shelley Burnett. All panelists agreed that technology is a crucial enabler for both better patient care and adherence and to help pharmacies handle the complexities of providing specialty pharmacy care.“The next time you think you want to hire a staff member, instead hire a piece of software, a new system instead that will enable you to do more with your current team,” suggested Nicholas Hui, co-founder of MedMe Health.These trends all point towards a new reality for the growing area of specialty pharmacy, noted Neighbourhood Pharmacy CEO Sandra Hanna. “Could we start to see the emergence of community-based oncology pharmacies and metabolic pharmacies?”One message was repeated numerous times throughout the two days of the summit: The time is right for community pharmacies to step into the specialty pharmacy arena. Whether by starting with a few loyal patients who needs specialty medications, or by following your area of interest to develop a practice based on a disease or condition managed by specialty drugs, it is time to start.Many presenters stressed starting on a small scale and working towards excellent care. As El-Kholi said, repeating a maxim that was heard often throughout the event: “You can do anything. But you can’t do everything.”

Specialty pharmacy a rapidly-emerging area of practice

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