Imagine a place where all specialty pharmacies and their partners gather together. This year’s Asembia Specialty Pharmacy Summit conference, held April 29 – May 2 in Las Vegas, saw more than 6,000 attendees for three full days of networking and information sharing, and more than 150 exhibitors spanning the specialty pharmacy industry.
Sentry was able to meet at the event with our industry peers in the hospital, specialty pharmacy, wholesaler, and consultant spaces to discuss the intersection of 340B and specialty.
What is the specialty pharmacy industry?
The specialty pharmacy industry is a vast group of stakeholders working in collaboration with drug distribution channels, dispensaries, and more importantly, drug manufacturers and payers. Many attendees join this meeting specifically to have one-on-one discussions with the latter, seeking information about clinical programs and about outcomes moving in the direction of value-based purchasing. Additionally, drug manufacturers use the forum to showcase new drugs and demonstrate clinical efficacy to payers. Finally, hospitals discuss their comprehensive care models and share statistics on reducing readmission rates and improving physician communications, which leads to patients receiving therapy sooner.
While specialty pharmacy is no stranger to healthcare, it’s an emerging industry that captured 43% of total US drug spend in 2017—increasing by more than 9% from the previous year. Traditional drug spend is decreasing, while specialty pharmacy areas such as biosimilar and gene therapy are areas where we are seeing continued growth. Doug Long, VP of industry relations at healthcare data and technology organization IQVIA (the company formed from the 2016 merger of IMS Health and Quintiles), presented trends in specialty pharmacy, and to no one’s disappointment, Long continued to keep us informed on pharmaceutical ‘spend,’ which increased by $6 billion in 2017.
Focus on technology
Technology solutions, from patient monitoring programs to robotics supporting compliance in high-cost drug markets, drew great interest from the attendees. Vertical integration played into conversations about the future of specialty, as it has with other sectors of healthcare, from Amazon to the more recent insurance acquisitions involving PBMs and pharmacies. There was also a great deal of speculation about future possible moves.
Health system specialty pharmacies played a role in the conference as well, presenting their comprehensive care models as differentiators in documenting improved outcomes. Their unique ability to follow the patient journey from initial visit to lab testing to monitoring illustrates streamlined efficiencies and relationships with providers. The struggle many health system specialty pharmacies face is access.
340B took center stage with Drug Channels’ CEO Adam Fein, who pointed to hospitals for increased drug costs, while consulting firm Avalere Health discussed the Medicare Part B change and reported that hospitals are “making money” since the regulation implementation. Yet, as we know, hospitals are currently entangled in a lawsuit with HHS for the financial loss and burden of caring for the uninsured under the new regulation. “The impacts of the cuts to the 340B Drug Pricing Program on nonprofit hospitals that rely on 340B drug savings will likely weaken their operating performance at a time of already tightening margins,” according to a new report from market intelligence firm S&P Global. “This could lead to negative rating actions if hospital-specific funding reductions were material and not offset by other management actions.”
Of interest to 340B hospitals impacted by the orphan drug exclusion was a growing number of products for personalized medicine that will soon be introduced to the market and will come with higher costs. In addition, there were presentations about clinical programs focused on cystic fibrosis, hemophilia, rheumatoid arthritis, and how to implement value-based care models. Again, data was at the top of the charts in terms of being able to demonstrate improved outcomes.
What is ahead?
It’s safe to say that specialty pharmacy is not slowing down any time soon. It’s important for health systems to have a plan in this space to ensure that their patients have access to highly specialized drugs. Whether you are just starting a specialty pharmacy and going through the accreditation process with URAC and others, like CPPA, or you are deciding on whether to find a partner, Sentry can help you review the landscape and provide options based on your market. Specialty pharmacy is in an industry that requires constant monitoring; as new drugs come to market with limited distribution patterns, hospitals will need to make sure they have a strategy in place to fill the gaps for their patients.