Start or Grow a Specialty Pharmacy Service | Jim Motz, R.Ph. | RxEconsult

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How to Start or Grow a Specialty Pharmacy Service Category: Pharmacy by - May 28, 2013 | Views: 30268 | Likes: 1 | Comment: 0  

What are Specialty Pharmacy Services

What differentiates “specialty pharmacy” from traditional pharmacy services?  A simplified answer is that specialty pharmacies provide patients with a full range of “high touch” services, starting with an assessment of benefits and access to financial assistance programs to counseling at the first dispense and intensive monitoring for safety and therapeutic effectiveness throughout therapy.  Specialty pharmacy care is pharmaceutical care, albeit at a level that might be beyond the scope of that which traditional pharmacies are accustomed to offering their patients now.

That said, is it possible for a community pharmacists to become a player in specialty pharmacy?  Considering the explosive growth of specialty pharmacy drugs, and the impending “patent cliff” for common medications, the business case for specialty pharmacy becomes clear.  Here’s a list of action items pharmacy managers should be working on now (or better yet, have already started) to prepare their pharmacy for specialty services. 

Conduct an analysis of your existing business

For which specialty pharmacy conditions is your pharmacy already providing services?   Many pharmacies have patients using medications for rheumatoid arthritis, ulcerative colitis, multiple sclerosis and possibly other conditions.  These could represent initial opportunities for growth.

What local physicians are providing care to specialty pharmacy patients?  Are you prepared to meet with these physicians, ask about (and address) these physicians’ expressed needs for their patients? 

Which payers are allowing coverage for specialty medications at your pharmacy?  Can you meet with local payers who may not be contracted with your pharmacy for specialty services to expand your eligible patient population?

Consider your own expertise and skills

Are your clinical skills up to date, to allow full clinical management of specialty pharmacy patients?

Don’t exceed the limits of your skills.  Practice within your skill set, and if necessary, grow your skills before expanding to additional disease states.  Don’t overextend your services into areas for which you can’t offer high level services.  A negative outcome will significantly damage your service. 

Become adept at understanding all means of financial support available to patients.  Your technician staff can become invaluable in picking up this aspect of the service.  Don’t underestimate the value of techs in providing the high touch care your specialty patients expect.

Finally, give serious consideration to the next steps required to grow the service

Accreditation is becoming increasingly important.  Manufacturers and payers are looking to restrict availability to accredited pharmacies.  There is a steep cost to accreditation, but in the end, it may be necessary.

Pharmacist certifications and credentialing: Explore opportunities to become certified as a way to differentiate your services from that of competitors.  Every edge you gain will become important.

Keep in touch with payers and manufacturers.  It’s important to learn industry trends.  The best way to do this might be to attend a national specialty meeting every year or two.


To sum up, with every passing day the barriers for entry into specialty pharmacy become more significant.  If community pharmacies are serious about becoming a player in this field, the time for action is now.

Also Read:

How to Sell Non-covered Medical Services to Patients

How to Win a Medication Therapy Management (MTM) Contract


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