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AMCP 2016

The Future of Specialty Pharmacy: Where Do We Need to Go?

Laura Joszt
The specialty pharmacy industry is unique in many ways, but the price growth for these drugs is no longer sustainable, Steve Miller, MD, senior vice president and chief medical officer of Express Scripts, said during a pre-meeting session of AMCP Managed Care & Specialty Pharmacy Annual Meeting 2016.
The specialty pharmacy industry is unique in many ways, but the price growth for these drugs is no longer sustainable, Steve Miller, MD, senior vice president and chief medical officer of Express Scripts, said during a pre-meeting session of AMCP Managed Care & Specialty Pharmacy Annual Meeting 2016.
 
Dr Miller sat on a panel to discuss the future of specialty pharmacy during Specialty Pharmacy Connect, which convened on April 19, just ahead of the full annual meeting.
 
Phil Hagerman, RPh, CEO and chairman of Diplomat Pharmacy, echoed Dr Miller’s comment and kicked off the panel by explained that the landscape specialty pharmacy is interesting and competitive in a way that isn’t seen in other industries.
 
Importantly, specialty pharmacy is being led by the drug pipeline, he said, and oncology drugs are the leader in the space, accounting for close to 50% of the drugs currently in development. While other disease states may have once been a bigger concern regarding cost, because they had larger populations, oncology has a large number of drugs and orphan drugs coming to the market, he explained. And with breakthrough status, orphan drug status, and priority drug review vouchers, more of these drugs will be brought to the market faster.
 
Hagerman described drug launch years as a wine vintage: the cost is not necessarily in that first year. For example, at Diplomat in 2013, only 5% of sales came from drugs launched in 2013. In 2014, more than 20% of sales came from drugs launched in 2013. The challenge is that not only new drugs are driving spending. In addition, drugs that were launched earlier than 2013 grew by 50% over a 2-year period of time for Diplomat.
 
“So you’ve got a lot of old, established drugs in specialty still taking market share as new indications come out for those drugs, and you’ve got the new drugs driving tremendous profit,” he said. “It’s kind of a double whammy in healthcare here."
 
He finished his talk by discussing limited distribution, which he said is here to stay because it gives manufacturers the opportunity to control the patient experience in a way it hasn’t been able to since the clinical trial.
 


 
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