Specialty Pharmacy Drives Advanced Therapy Access: Fran Gregory, PharmD

Shifting advanced therapy administration from academic medical centers to community-based providers holds significant promise for reducing total cost of care while expanding patient access, and specialty pharmacies are the connective tissue that can make that transition work, according to Fran Gregory, PharmD, MBA, vice president of emerging therapies at Cardinal Health.

Why Community Sites Can Lower Total Cost of Care

Gregory framed the issue around a financial and logistical reality facing community oncology practices: the same move that brings patients closer to home also changes the cost calculus for payers. Although academic medical centers are centers of excellence with leading research, they tend to carry a higher total cost of care. Distributing patients to community sites has the potential to reduce costs tied to administrative site fees, a benefit Gregory said needs clearer recognition in policy and payer conversations.

"The movement to the community and potentially reducing the total cost of care is something that needs to be very clearly highlighted as a financial benefit of moving that patient to a location that's closer to home," said Gregory.

How Specialty Pharmacies Make the Transition Work

For community providers willing to take on advanced therapies, the clinical and operational lift is substantial. Practices must coordinate nursing staff, establish triage protocols, and manage patient escalation pathways. Gregory argued that specialty pharmacies can absorb much of that nonclinical administrative load, including securing reimbursement, coordinating patient schedules, and managing treatment logistics, freeing providers to focus on direct patient care.

That division of labor matters because the barriers to community administration are real. Physicians considering whether to bring advanced therapies into their practices face a layered set of decisions, and the ability to hand off administrative complexity to a specialty pharmacy partner can tip the calculus toward participation.

Specialty pharmacies also serve a longer-term function in the advanced therapy ecosystem. Gregory pointed to their role in real-world evidence collection, noting that patients tend to develop trust with their specialty pharmacy during treatment. That relationship creates a pipeline for longitudinal data that supports ongoing evaluation of these therapies outside clinical trial settings.

"Specialty pharmacies are really stepping into a sophisticated role in helping manage any complexity that they can kind of offload from the physician or the provider to make that provider's life easier," said Gregory.