For many health systems, investment in specialty pharmacy can generate positive patient outcomes alongside substantial revenues. We've seen tremendous growth of health system-owned specialty pharmacies (HSSPs) across the past decade. In fact, Advisory Board first wrote about the movement towards HSSPs in 2016, and has since published a library of resources to support pharmacy leaders as they start and grow their specialty pharmacy.
Still, health systems are grappling with how to transition their specialty pharmacy from a strategic investment to a sustainable, mature business. A lot of this pressure can be traced back to three key challenges.
HSSPs invest substantial resources into patient care, which helps them garner high patient satisfaction rates and strong clinical outcomes—even besting clinical trials in some cases. However, most HSSP leaders say that these levels of care would not be possible without the benefit of 340B savings.
Health system leaders are wrestling with whether to continue investing in robust staffing to support growth and superior outcomes, or to experiment with leaner staffing models in anticipation of limits on 340B-related savings.
Health systems can be reassured by the fact that 340B is unlikely to completely disappear. However, they must monitor key issues that may influence their ability to access 340B savings in the future.
We've seen tremendous growth in the specialty pharmacy market, and it is poised for more, largely driven by new-to-market drugs. On the surface, this growth could be a win for HSSPs: drugs with bigger margins, treatments for patients who may not have had such options previously, and improvement in the overall quality of care. However, these new drugs are also introducing new complexities.
Successful HSSPs are finding that the ability to demonstrate outcomes and communicate the specialty pharmacy's value is becoming increasingly critical to access both limited distribution drugs and to be included in health plan pharmacy networks.
Emerging value-based care models may also increase the demand for specialty pharmacy outcomes data, including the impact on total cost of care. However, HSSP leaders almost universally report facing challenges to effectively collecting and analyzing patient outcomes data.
Six years ago, Advisory Board began writing about specialty pharmacy. Since then, we've seen massive growth in HSSPs across the country. We anticipate that the next six years will be full of many more changes in this rapidly evolving space.
We continue to ask: what will specialty pharmacy look like in the future? One thing is clear. HSSPs will need to adapt to market changes and think beyond the initial investment to meet future challenges head on.
If you are interested in contributing your perspective to Advisory Board's ongoing research on the future of specialty pharmacy, please email Chloe Bakst (firstname.lastname@example.org). We welcome conversations from the health system, pharmaceutical manufacturer, PBM, or health plan point of view.
Many health systems are investing in integrated specialty pharmacies that dispense and manage specialty medications for health system patients and employees.
We've compiled a library of our top resources and case studies to support leaders as they start and grow their system-owned specialty pharmacies, from making the initial case for investment to expanding services to all specialty patients and beyond.
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