The number of accredited specialty pharmacies in the U.S. is growing. According to a recent analysis by Alan Fein, Ph.D., of Drug Channels, the total number of such pharmacies now exceeds 700. This is a 46% increase from 2016, which was a 32% increase from the year before. In other words, growth is accelerating, not slowing down. For pharmacists already involved in specialty pharmacy distribution, this is good news for your job market. And for pharmacists or technicians interested in shifting career focus, specialty pharmacy is not a bad direction to go in.
In theory, any retail pharmacy can be involved to some degree in the distribution of specialty pharmacy drugs. But several factors tend to direct most of the specialty pharmacy dispensing to facilities that focus specifically on this function. The first reason for this is that specialty pharmacy medications almost all require a prior authorization process for approval. As such, many specialty pharmacies provide services to help begin the steps needed for a prior authorization review by the payer. Patient eligibility for these medications requires the collection and retention of information about diagnosis, prior therapies tried and patient lab values that many pharmacy software systems are not designed to record.
In addition to the prior authorization process, specialty pharmacy medications often require additional patient education, monitoring and adherence support to ensure that the treatment, often costing tens of thousands of dollars, will be effective. Specialty pharmacies employ clinical pharmacists to assist in working with patients and providers to ensure the therapy is appropriate, and that it is working. Pharmacists are available, sometimes 24/7, to field questions from patients about their medication, side effects or potential drug interactions.
Finally, specialty pharmacy products often require additional financial support to help cover the costs associated with these expensive treatments. Even when covered by insurance, copays and deductibles can run into the thousands of dollars. Therefore a team of trained benefits specialists, often pharmacy technicians with access to additional resources are employed to help make sure that the prescribed medications, once approved, will also be affordable.
The market growth and unique demands of specialty pharmacy make this an area of potential specialization for pharmacists and pharmacy technicians. As such, a nationally recognized certification program is available to pharmacists who want to focus their career in this area. Available through the Specialty Pharmacy Certification Board (SPCB) this credential can be obtained by pharmacists currently working in a specialty pharmacy environment and who can pass an examination of their knowledge of the subject matter.
Another unique aspect to a career in specialty pharmacy is the fact that many such pharmacies must go through a rigorous credentialing process if they wish to become eligible to dispense specialty products for a PBM. Credentialing is primarily done by 1 or more of the following 3 agencies: the Accreditation Commission for Health Care, the Utilization Review Accreditation Commission, or the Center for Pharmacy Practice Accreditation. The function of the credentialing process helps guarantee that the pharmacy is practicing according to standards that will maximize patient safety, access, adherence and positive outcomes. Pharmacists familiar with the process of credentialing and maintaining such credentials can be valuable to health systems that are looking to grow in this area.
Where would you work as a specialty pharmacist or technician? With over 700 accredited, and many more non-accredited, specialty pharmacy dispensing sites, you could work just about anywhere. You could work at a local hospital or health system that has their own specialty pharmacy. This is one of the fastest growing categories of specialty pharmacies. But you could also work at one of the many dispensing sites for any of the national specialty pharmacy businesses such as CVS Health, Accredo, Walgreens, Briova, Diplomat, and many others.
Specialty pharmacy is here to stay. And with nearly 300,000 licensed pharmacists in the U.S. it is becoming ever more important to find ways to stand out in your career. As you consider your professional options, specialty pharmacy may be something worth researching.