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Specialty drugs are high-cost prescription medications that are used to treat complex, chronic conditions.

Healthinsurance.org, LLC (HIO). (2020). What is a Specialty Drug? Healthinsurance.Org. Retrieved June 26, 2022, from https://www.healthinsurance.org/glossary/specialty-drug/

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Specialty drugs are high-cost prescription medications used to treat complex, chronic conditions like cancer, rheumatoid arthritis, and multiple sclerosis.

Specialty drugs sometimes require special handling and administration (typically injection or infusion), and patients using a specialty drug may need careful oversight from a health care provider who can watch for side effects and ensure that the medication is working as intended.

Specialty drugs might be covered through either medical or prescription drug insurance. How a specialty drug is covered usually depends on where the patient receives the drug. If the patient takes a pill or self-injects the drug at home, it is more likely to be covered through his or her prescription drug benefit. If the patient receives the drug at a doctor’s office or an outpatient clinic, it’s more likely to be covered through the medical benefits portion of his or her health insurance coverage.

Specialty drugs are very expensive – often $1,000 or more per month – and spending on them is growing 15 to 20 percent a year. Many prescription drug plans that cover specialty drugs have a separate “tier” that specifies how much an individual has to pay for specialty drugs. Individuals may be required to pay a percentage of the drug cost or a flat-dollar copay. Copays are fairly rare for specialty drugs (it’s more common for plans to require patients to pay a percentage of the cost instead), but when they are used, they tend to be several hundred dollars. There are several states, however, that have capped patients’ out-of-pocket costs for specialty drugs.

Many drugs manufacturers offer patient assistance programs to help people with and without insurance get access to specialty drugs.

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Specialty drugs are high-cost prescription medications used to treat complex, chronic conditions like rheumatoid arthritis, multiple sclerosis, and cancer. These medications often require special handling and administration.

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A medication is defined as "specialty" if it requires special handling, special administration, monitoring; or, is a high-cost oral medication.

Michigan Medicine. (2019, January 4). Specialty Medications by Condition | Michigan Medicine. Uofmhealth. Retrieved June 26, 2022, from https://www.uofmhealth.org/conditions-treatments/specialty-pharmacy-services/specialty-medications-condition#:%7E:text=A%20specialty%20medication%20is%20a,a%20high%2Dcost%20oral%20medication.

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A specialty medication is a prescription drug that is either a self-administered (non-diabetic) injectable medication; a medication that requires special handling, special administration, or monitoring; or, is a high-cost oral medication.

Specialty medications are used to treat patients with complex and/or rare diseases; have special dosage, storage, handling, and administration requirements; and require high touch patient care and monitoring services (eg, transplant, oncology, MS, hepatitis).

Below are conditions and diseases for which we provide medications. Click on the link to find out more information about medications specific to each.

Antiretroviral Medications

Cardiology Medications

Dermatology

Fertility

Gastroenterology

Growth Hormone Deficiency

Hepatitis

Multiple Sclerosis

Oncology (Cancer) Medications

Pulmonology

Rheumatology

Transplant

Miscellaneous

Contact Us

Visit our Contact Specialty Pharmacy Services page for information about our locations, phone numbers and email addresses, including what to include when requesting medication refills. For information about general pharmacy services visit the Pharmacies page in our Patient and Visitors section.

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Specialty Medications by Condition | Michigan Medicine

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U-M Specialty Pharmacy provides specialty medications used to treat patients with complex or rare diseases requiring high-touch care and monitoring.

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1. Inflammatory Conditions
2. Multiple Sclerosis
3. Oncology
4. Hepatitis C
5. HIV
6. Growth Deficiency
7. Cystic Fibrosis
8. Pulmonary Hypertension
9. Hempphilia
10. Sleep Disorders

Lauren Santye, Assistant Editor. (2022, January 4). Top 10 Specialty Drug Therapeutic Classes. Pharmacy Times. Retrieved June 26, 2022, from https://www.pharmacytimes.com/view/top-10-specialty-drug-therapeutic-classes

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In 2015, specialty medications accounted for 37.7% of total drug spending and a 17.8% overall trend, according to the annual Express Scripts Drug Trend Report.

The report analyzes US prescription medication costs and utilization, with marketplace factors that impact future changes. All of the top 10 specialty therapy classes increased in spend and in the unit cost of medications.

The top 3 specialty therapy classes, which includes multiple sclerosis, oncology, and inflammatory conditions, accounted for 56.3% of all specialty spend.

Below are the top 10 specialty therapy classes for 2015:

10. Sleep disorders

Despite low market share, this class was able to make the top 10 specialty medications easily due to the average cost per prescription of about $9000. The PMPY spend increased by 24.1%, which was influenced by an 18.5% increase in cost and 5.5% increase in utilization.

Currently, sodium oxybate (Xyrem) and tasimelteon (Hetlioz) account for 100% of the market share in this class.

9. Hemophilia

There was a 15.4% increase in unit cost, which contributed to the rise in spend for 2015. Brand inflation for antihemophilic and clotting drugs, such as antihemophilic factor (recombinant) (Eloctate), which had a triple digit utilization and unit cost increases, also contributed to the increase. This particular class has a small market share and a high average cost of therapy, so even a small utilization increase can have a large impact on overall spend.

8. Pulmonary hypertension

The 13.4% utilization increase and 4.8% unit cost increase were responsible for the increased trend by 18.1% in 2015. Utilization increased for 7 of the 10 top drugs in spend for this class. Sildenafil is still the most prescribed drug in the class, accounting for 36.4% of the market share. The drugs treprostinil (Orenitram), macitentan (Opsumit), and rociguat (Adempas) increased in utilization by 315.8%, 111.2%, and 72.3%, respectively. Orenitram decreased by 53.2% in unit cost, which most likely played a role in the increased utilization.

7. Cystic fibrosis

The trend for this class of medications reached 53.4% in 2015. This class only consists of 10 drugs with an average cost per prescription of $6,441.27. One of the 2 most costly drugs for cystic fibrosis approved in mid-2015 is lumacaftor/ivacaftor (Orkambi), which helped drive the trend.

6. Growth deficiency

The trend for rare condition growth deficiency was 5.6% as a result of equal trend in utilization and unit cost (2.8%). For the fourth consecutive year, somatropin (Norditropin, Flexural) dominated the class and accounted for 49.1% of market share. Norditropin is the highest spend within the class and increased in unit cost and utilization by almost 11%. The second drug in spend is somatropin (Genotropin), but the trend decreased by 12%, which was largely in part to an 11.3% decrease in unit price. The highest trend in 2015 was mecasermin (Increlex), which had an overall increase in spend of 140.6% because of a 126.8% increase in utilization.

5. HIV

Brand inflation and utilization drove the trend for HIV drugs, with 6 of the top drugs increasing in spend by double and triple digits in 2015. There was a 4.6% increase in utilization and a 12% unit cost increase, which contributed to the overall 2015 trend increase of 16.6% in PMPY spend, which moved it up to fifth place in the most expensive specialty therapy class.

4. Hepatitis C

In 2014, there was a record increase in spend because of new and effective oral antiviral therapies with an expensive price tag. However, the 2015 trend was lower with a spend increase of 7%. Utilization decreased 2.2%, while there was a 9.2% increase in unit cost that was responsible for driving a majority of the change in spend.

Viekira Pak and Harvoni, which were approved in 2014, accounted for more than 57% of market share for hepatitis therapy.

3. Oncology

The FDA approved 10 oncology therapies in 2015, which helped increase spend 23.7%, while the increase in utilization (9.3%) and unit cost (14.4%) helped drive the trend. The oncology treatment Gleevec and lenalidomide (Revlimid) account for more than 22% of the market share, with Gleevec comprising the largest market share at an increase in unit cost by 19.3%.

2. Multiple sclerosis

MS ranked at number 2 in total trend for medications at 9.7%. The increase found in unit cost (6.2%) and utilization (3.5%) helped drive the total trend. The overall trend was especially influenced by the increase in unit price of the top 5 most prescribed medications, which accounted for 84% of the spend. The unit cost increase for MS drugs was between 3.8% and 9.4%, with glatiramer (Copaxone) being the most widely used and having the highest spend in the class, but a generic version was launched in June 2015.

1. Inflammatory conditions

When ranked by per member per month (PMPY) spend, inflammatory conditions remained at the top of specialty therapy classes for the seventh consecutive year, trending at 25%. Most of the top drugs within the class are disease modifying anti-rheumatic drugs (DMARDs) responsible for treating psoriasis, rheumatoid arthritis, inflammatory bowel disease, and other conditions as well.

Additionally, the top 2 drugs adalimumab (Humira) and etanercept (Enbrel) saw an increase in unit cost.

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Top 10 Specialty Drug Therapeutic Classes

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In 2015, specialty medications accounted for 37.7% of total drug spending and a 17.8% overall trend, according to the annual Express Scripts Drug Trend Report. The report analyzes US prescription medication costs and utilization, with marketplace factors that impact future changes. All of the top 10 specialty therapy classes increased in spend and in the unit cost of medications.

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As of 2020, Specialty Pharmaceuticals accounted for 50% of prescription costs despite representing only 1% to 3% of prescriptions written by medical professionals.

Specialty pharmacy costs were considered the top driver of rising health care costs in 2017. Eight in 10 employers ranked it among the top three factors in pushing health care costs higher.

The top five most expensive specialty pharmacy drugs cost, on average, $104,000 annually.

As a result many patients with complex and rare conditions that required specialty drug treatment were unable to afford copays to access their medications.

Ikeya, A. (2019, April 1). Containing the Escalating Costs of Prescriptions. Biz Journals. Retrieved June 26, 2022, from https://www.bizjournals.com/sanfrancisco/news/2019/04/01/containing-the-escalating-costs-of-prescription.html

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AARP found that the average annual cost for just one specialty medication used on a chronic basis is $78,781.

Specialty Prescription drugs are 12 times more expensive than brand name drugs and 215 times more expensive than generic name drugs.

Specialty drug prices soaring past six figures per year. (2019, July 26). YouTube. Retrieved June 26, 2022, from https://www.youtube.com/watch?v=Fr9i2ZceJgg

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Specialty drug prices soaring past six figures per year

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Spending on specialty drugs has increased by 361% from 2012-2020

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Squires, T. M. (2022, June 6). Post author: Tyrone Squires, MBA, CPBS. TransparentRX. Retrieved June 26, 2022, from https://transparentrx.com/infographic-the-cost-of-innovation-how-specialty-drugs-impact-healthcare/

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The high cost of specialty drugs can be attributed to the special handling they often require: prescription from a specialist, administration by a medical professional in a clinical setting, and significant patient management to make sure the drugs are being used correctly and safely.

The High Costs of Specialty Being Used Correctly and Safely. (2020, March 28). WellMark. Retrieved June 26, 2022, from https://www.wellmark.com/blue-at-work/resources/specialty-drug-prices#:~:text=The%20high%20cost%20of%20specialty,being%20used%20correctly%20and%20safely.

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Copays for employees for specialty medication have increased by 229% since 2010

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Workers Face Increased Copays for Specialty Drgs

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Workers Face Increased Copays for Specialty Drgs

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Squires, T. M. (2022, June 6). Post author: Tyrone Squires, MBA, CPBS. TransparentRX. Retrieved June 26, 2022, from https://transparentrx.com/infographic-the-cost-of-innovation-how-specialty-drugs-impact-healthcare/

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The prior authorization process – a prerequisite for specialty medication therapy – is intended to ensure patients receive appropriate and effective treatment. However, it is one of many barriers to specialty medication access that can delay or prevent patients from starting therapy and create additional stress for patients and their caregivers.

Edwards, K. (2020, February 20). Embedded Specialty Pharmacy Team Removes Barriers to Specialty Medication Access. Trellis Rx. Retrieved June 26, 2022, from https://www.trellisrx.com/removing-barriers-to-medication-access/

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Published 04/17/2019
by Kathryn Edwards

The prior authorization process - a prerequisite for specialty medication therapy - is intended to ensure patients receive appropriate and effective treatment. However, it is one of many barriers to specialty medication access that can delay or prevent patients from starting therapy and create additional stress for patients and their caregivers.

Obtaining prior authorization is also time-consuming for providers . In 2013, one survey found doctors and nurses in a typical medical office spend around 14 hours each week on prior authorizations and appeals. T his adds up for health systems. A study examin ing primary care practices estimated the prior authorization process cost s up to $3,430 per physician annually.

Clinic-Based Specialty Pharmacy Services Remove Barriers to Specialty Medication Access

Health systems can lessen the burden of prior authorization s on patients and providers by offering clinic-based s pecialty pharmacy services . At our partner health systems, pharmacy liaisons are embedded in specialty clinics to proactively manag e prior authorization s. They also handle appeals , f inancial assistance applications, refill reminders, prescription deliveries, and more.

Being on-site helps in-clinic specialty pharmacy liaisons accelerate prior authorization s because they have direct access to patients' care teams and medical records. This allows them to obtain information required for prior authorizations more quickly than external specialty pharmacies can . B ecause they are held accountable for providing exceptional, timely patient care, they are persistent about following-up with health plans - often checking in daily until approval is received.

Specialty Pharmacy Liaisons Go Above and Beyond for Patients

T he pharmacy liaisons at our partner health systems also get to know patients personally. This pushes them to go above and beyond to help patients access medications even when prior authorization and appeals are denied. A recent story shared by a pharmacy liaison at a partner health system illustrate s th eir dedication:

Health System Specialty Pharmacy Programs Benefit Providers Too

An on-site specialty pharmacy program also removes the administrative burden specialty medications create for doctors and nurses. This enables them to spend more time on face-to-face patient care. When in-clinic pharmacy liaisons started managing prior authorization and other administrative tasks associated with specialty medications, o ncologists at one of our partner health systems gained 10 percent more capacity to devote to patient care .

Integrating specialty pharmacy services at your health system can remove barriers to specialty medication access helping patients access needed medications and boosting providers' satisfaction. to read another blog post about other ways an on-site specialty pharmacy program can improve your patients' experiences and health outcomes. Or contact us directly to discuss your health system's specialty pharmacy growth opportunity.

1. Casalino LP, Nicholson S, Gans DN, et al. What does it cost physician practices to interact with health insurance plans?. Health Aff (Millwood). 2009;28(4):w533-43.

2. Morley CP, Badolato DJ, Hickner J, Epling JW. The impact of prior authorization requirements on primary care physicians' offices: report of two parallel network studies. J Am Board Fam Med. 2013;26(1):93-95.

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Remove Barriers to Medication Access with Embedded HSSP | Trellis Rx

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Published 04/17/2019 by Kathryn Edwards The prior authorization process - a prerequisite for specialty medication therapy - is intended to ensure patients receive appropriate and effective treatment. However, it is one of many barriers to specialty medication access that can delay or prevent patients from starting therapy and create additional stress for patients and their caregivers.

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How Health Insurance Prior Authorizations Work

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How Health Insurance Prior Authorizations Work

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How health insurance prior authorization works. YouTube. (2020, July 27). Retrieved June 28, 2022, from https://youtu.be/3yd6NpFyK50

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Texas Family Insurance: Obamacare Open Enrollment

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How Health Insurance Prior Authorization Works

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Eighty-two percent of those prescribed specialty therapies reported spending an hour on the phone coordinating care to begin their therapy. Over a third spent at least three hours. Medication access and adherence challenges can be so significant for specialty patients, up to 27% of prescriptions and therapies are abandoned—or never started at all.

Conroy, E. C. (2021, March 23). Specialty access barriers: How technology can help. Pharmaceutical Commerce. Retrieved June 26, 2020, from https://www.pharmaceuticalcommerce.com/view/specialty-access-barriers-how-technology-can-help

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Channels leading to dispensing of specialty products under the pharmacy benefit

Fein, A. J., PhD. (2018, July 12). Useful Overview of Specialty Distribution Models. Drug Channels. Retrieved June 26, 2022, from https://www.drugchannels.net/2012/07/useful-overview-of-specialty.html

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Eighty-five percent of manufactures  manage some or all products through a limited distribution model according to the 2019 State of Specialty Pharmacy Report.

Pharmacy, A. S. (2020, February 4). What Are Limited Distribution Drug Networks, Anyway? Avella. Retrieved June 26, 2022, from https://blog.avella.com/what-are-limited-distribution-drug-networks-anyway

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Many of the specialty medications used to treat complex, chronic conditions are delivered through limited distribution. Limited distribution drugs (LDD) are therapies only made available to a small number of pharmacies-and though there are reasons for these limitations, they sometimes make it difficult for patients to access medications as needed.

This article covers what limited distribution drugs are, why limitations exist, and how pharmacies can access manufacturer networks.

Understanding Limitations in Specialty Drug Distribution

According to the 2019 State of Specialty Pharmacy Report, nearly 85 percent of manufacturers manage some or all products through a limited distribution model.

Why do so many drug manufacturers limit distribution of lifesaving medications? There are many benefits to limiting drug distribution within specialty pharmacy networks, including greater control and oversight from manufacturers.

Because limited distribution allows for closer patient relationships with prescribers and pharmacists, patients are typically more adherent to prescribed medications and more likely to have optimal treatment outcomes. This includes avoided or early-detected adverse events which can often lead to hospitalization or a patient to stop taking their medication. Limiting the size of specialty networks allows for greater oversight and quality, ensuring that only highly trained clinical staff are dispensing medications and supporting patients.

Additionally, limiting the size of a network ensures greater consistency and less variability of care. Here's how an experienced pharmacist explained the issue:

"Drug manufacturers may have the ability to produce a limited supply of drugs to assure every patient who begins therapy will be able to have continued access to the drug; however, the number of pharmacies in the distribution network is limited to specialty pharmacies.

Limited access can be viewed as minimizing the competition, but the clinical benefits to the patient and accuracy of data collection and analysis is a benefit that counters this argument. A limited network can be beneficial to the manufacturer, the physician, the payer, patient and pharmacy, as every one of these entities must coordinate their efforts to get a patient set up correctly from the start of therapy."

Accessing Limited Networks: How Pharmacies are Selected

Manufacturers identify specialty pharmacies that have the highest standards for clinical excellence, patient education, treatment monitoring, and customer support. There are several key criteria considered by drug manufacturers when selecting specialty pharmacies for limited distribution networks, such as:

Clinical expertise, which is determined by everything from years of experience and number of patients served to background distributing similar therapies and manufacturer relationships

Disease-state-focused care coordinators to support patients

National accreditation to ensure proper storage and handling

Medication adherence tools and support services

Financial assistance/prior authorization services

Advanced clinical, dispensing, inventory, and sales data

Payer access and established relationships

How Avella is Leading in Limited Drug Distribution

Avella has been selected as a limited distribution partner by several leading manufacturers based on decades of industry experience, high-touch patient services, extensive payer coverage, and strong relationships with prescribers. As a result, Avella dispenses more than 65 limited distribution drugs, the majority of which are in oncology, including those that are most difficult for patients to attain.

Learn more about the wide range of limited distribution drugs Avella offers to patients treating complex conditions in our whitepaper: Limiting Distribution, Unlimited Potential

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What Are Limited Distribution Drug Networks, Anyway?

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Many of the specialty medications used to treat complex, chronic conditions are delivered through limited distribution. Limited distribution drugs (LDD) are therapies only made available to a small number of pharmacies-and though there are reasons for these limitations, they sometimes make it difficult for patients to access medications as needed.

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Specialty pharmacies provide services that include training in how to use these medications, comprehensive treatment assessment, patient monitoring, and frequent communication with caregivers and the patient’s physician or other health care providers.

Byrne, M. P. (2021, March 5). The Ins and Outs of Specialty Pharmacy. Pharmacy Times. Retrieved June 26, 2022, from https://www.pharmacytimes.com/view/the-ins-and-outs-of-specialty-pharmacy

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Formerly an obscure subsection of the pharmacy sector, specialty pharmacy is now an area that most health care professionals recognize. Specialty products now dominate the drug pipeline, having gained more approvals than traditional medications since 2010. Specialty medications are the major reason for increased drug spending, which is anticipated to hit $400 billion by 2020.

The National Association of Specialty Pharmacy (NASP) was founded in 2012 to support the rapidly growing specialty pharmacy industry. Without an intimate knowledge of the industry, some may ask, "What makes these specialty drugs so special?" Drugs are classified as specialty products most often due to the cost and complexity of the therapy.

NASP defines specialty pharmacy as "a state-licensed pharmacy that solely or largely provides only medications for people with serious health conditions requiring complex therapies. These include conditions such as cancer, hepatitis C, rheumatoid arthritis, HIV/AIDS, multiple sclerosis, cystic fibrosis, organ transplantation, human growth hormone deficiencies, hemophilia, and other bleeding disorders. In addition to being state-licensed and regulated, specialty pharmacies should be accredited by independent third parties, such as URAC, the Accreditation Commission for Health Care, the Center for Pharmacy Practice Accreditation, or the Joint Commission, in order to ensure consistent quality of care."

Specialty pharmacies connect patients who are severely ill with the medications that are prescribed for their conditions, provide the patient care services that are required for these medications, and support patients who are facing reimbursement challenges for these highly needed but also frequently costly medications.

Specialty medications have a complex profile that require intensive patient management and, in some cases, special handling. Although some are taken orally, many of these medications need to be injected or infused, at times in a physician's office or hospital.

Specialty pharmacies provide services that include training in how to use these medications, comprehensive treatment assessment, patient monitoring, and frequent communication with caregivers and the patient's physician or other health care providers.

The expert services that specialty pharmacies provide drive adherence and persistency, proper management of medication dosing and adverse effects, and ensure appropriate medication use. The specialty pharmacy patient-centric model is designed to provide a comprehensive and coordinated model of care for patients with chronic illnesses and complex medical conditions, achieve superior clinical and economic outcomes, and expedite patient access to care."

The American Pharmacists Association describes specialty medications as having some or all of the following key characteristics:

Treatment of complex, chronic, and/or rare conditions.

High cost, often exceeding $10,000, with some costing more than $100,000 annually.

Availability through exclusive, restricted, or limited distribution.

Special storage, handling, and/or administration requirements.

Ongoing monitoring for safety and/or efficacy.

Risk evaluation mitigation strategy.

Although the origins of specialty pharmacy began with oral transplant and HIV therapies, most people associate medications falling into this category as injectable or infusion products. Most recently, oral oncolytics have dominated the industry with respect to new drug launches.

Specialty pharmacies are designed to manage patients with these disease states. Along with a disease state knowledge-base, these pharmacies have tools to complete the required handling, storage, and distribution of complex medications that require high-touch patient management.

The American Pharmacists Association lists some of the services offered by specialty pharmacies that go beyond the typical retail level:

24-hour access to pharmacists

adherence management

benefits investigation

communication and follow-up with the physician

dispensing of specialty pharmaceuticals and shipping coordination

enrollment in patient assistance programs

financial assistance

patient education and medication adverse effect counseling

patient monitoring for safety and efficacy

payer and/or manufacturer reporting

proactive patient outreach for prescription refill and renewal

prior authorization assistance

Several specialty medications belong to an exclusive or limited distribution network. This model restricts the distribution channel for a pharmaceutical product to one (exclusive) or a few (limited distribution) network of pharmacies. There are several reasons why a pharmaceutical manufacturer may choose this type of distribution model.

First, it can ensure safe distribution of high-risk medications to small patient populations. Second, it allows the manufacturer to have added control over the patient's experience with their product.

Pharmacies who agree to the limited distribution network make promises to follow specific procedures outlined by the manufacturer to aid in patient safety, adherence, and outcomes. Examples of this may include how often outreach is made for counseling and/or order scheduling, patient education provided by the pharmacy, the type of information collected from the patient and/or prescriber, or financial assistance programs offered.

This information may be useful for manufacturers to evaluate the collected data for trends, which is made possible by working with a smaller number of pharmacies. Although specialty pharmacy medications are the minority of available drug products, they are the most costly and complex.

Specialty pharmacies have the required infrastructure to manage patients and their medications needed to treat these complex disease states.
Works Cited
Dimensions: Specialty Management Solutions. http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=21176. Published May 16, 2016. Accessed August 2, 2018.

Emerging Trends in the Specialty Drug Industry. Drug Topics. https://www.elsevier.com/__data/assets/pdf_file/0020/317432/Emerging-Trends-in-the-Specialty-Drug-Industry_eBook.pdf. Accessed August 2, 2018.

NASP Definitions of Specialty Pharmacy and Specialty Medications. http://naspnet.org/wp-content/uploads/2017/02/NASP-Definitions-final-2.16. Published February 24, 2016. Accessed August 2, 2018.

Specialty pharmacy: A unique and growing industry. Home. https://www.pharmacist.com/specialty-pharmacy-unique-and-growing-industry. Accessed August 2, 2018.
About the AuthorMichelle Byrne earned her Doctor of Pharmacy degree from Duquesne University and is currently enrolled in the Master of Science in Pharmacy Business Administration (MSPBA) program at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow's leaders in the business of medicines. Michelle has worked in the specialty pharmacy industry for the past 9 years, starting as a clinical pharmacist and working in leadership roles within her organization. Michelle's current role is Pharmacy Manager, Quality & Regulatory and Pharmacist-in-Charge for her site within the Specialty Operations division of her organization.

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Formerly an obscure subsection of the pharmacy sector, specialty pharmacy is now an area that most health care professionals recognize. Specialty products now dominate the drug pipeline, having gained more approvals than traditional medications since 2010. Specialty medications are the major reason for increased drug spending, which is anticipated to hit $400 billion by 2020.

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The field of specialty pharmaceuticals is a lucrative field that serves a patient population with complex and chronic conditions.

Any drug can be considered "specialty" if it meets certain requirements such as being high cost or requiring special handling or administration.

Patients who are on specialty medications on average can spend over $104K annually on these agents.

The nature of the specialty pharmacy industry mandates patients to utilize in network, limited distribution facilities that often make it very costly and difficult to receive these medications for both the patient and the healthcare providers trying to prescribe them.

Specialty pharmaceuticals is the top driver of rising health care costs and accounts for half of all prescription costs globally.

Due to distributing workflows mandated by drug manufactures, the complexity of navigating specialty pharmacies for newly enrolled patients and the exorbitant cost of these agents there exists delayed treatment or absence of treatment overall for this patient population.