Specialty pharmaceuticals continues to gain strength

CVS Caremark projects spending on specialty drugs to exceed $105 billion in 2015. The large PBMs are positioning themselves to take advantage of this growing opportunity. With a little less publicity, a number of the smaller specialty pharmacies are not staying on the sidelines just viewing the larger company activities.

Recently, CVS Caremark entered into a 12-year contract with Aetna to manage purchasing, inventory management and prescription fulfillment for Aetna’s mail order and specialty pharmacy operations. CVS Caremark also announced a new medical benefit drug management service for the company’s pharmacy benefit management (PBM) and specialty pharmacy clients. The offering provides a comprehensive management solution for the buy-and-bill drug model currently used by physicians (whereby the physician purchases specialty medications, administers them to the patient and directly bills the payer).  CVS Caremark will work with New Century Health, a specialty care management company, to offer its clients integrated evidence-based medicine, treatment care pathways, quality improvement programs, and peer-to-peer review through an innovative web-based decision support platform.

Express Scripts recently announced the formation of Express Scripts Specialty Benefit Services. Express Scripts now delivers plan sponsors a first-in-the-industry offering that enhances patient care across the pharmacy-medical spectrum, and guarantees savings on the specialty medical drug spend. Express Scripts is the first PBM to bring together the three functional areas needed to comprehensively manage specialty benefits: 1) pharmacy benefit management, 2) specialty pharmacy and distribution and 3) medical benefit management. The vital third component – medical benefit management – is delivered through the company’s subsidiary, Care Continuum(TM). By integrating core PBM and pharmacy services with expanded capabilities through Care Continuum, Express Scripts offers a solution to specialty patient care and trend management across both pharmacy and medical benefits.

Omnicare announced a strategic reorganization of its Pharmacy Services business into two groups; Long-Term Care and Specialty Care. Omnicare’s Specialty Care Group will consist of the Company’s specialty pharmacy and specialty pharmaceutical services businesses, Advanced Care Scripts, RxCrossroads, and Care For Life, as well as Omnicare’s hospice pharmacy and pharmaceutical case management business, excelleRx. Under the direction of newly appointed Specialty Care Group President, Nitin Sahney, Omnicare will focus additional resources on these growing businesses, further leverage existing capabilities, and pursue complementing avenues for growth.

Two years ago, Amber Pharmacy began expanding its specialty focus beyond transplants to hepatitis, oncology and multiple sclerosis. The company acted to diversify to take advantage of the growing market, especially oncology. Amber Pharmacy also formed a new company with Hy-Vee, Inc.  Hy-Vee Pharmacy Solutions will offer specialty pharmacy services through Hy-Vee’s retail stores.

Commcare Pharmacy acquired Pulmonary Prescription Providers, adding Home Infusion Capabilities to Commcare Pharmacy’s growing array of Specialty Pharmacy services. In addition, Commcare Pharmacy also gains expertise in pediatric RSV treatment, dialysis, and enteral therapies.

The Michigan Economic Growth Authority (MEGA) board approved a $61.5 million tax credit for Diplomat Specialty Pharmacy that that will allow the company to hire more than 1,000 people over the next five years and move its headquarters. Diplomat plans to invest $12 million over the next five years into what will become its national distribution center.

ICORE Healthcare launched a first-of-its-kind, clinically based program to manage rheumatoid arthritis and other autoimmune diseases — which will enable health plans to save up to $15,000 per patient per year. Autoimmune Connections lowers cost, develops consistent care programs and policies, and improves the quality of care.

SXC recently announced the completion of the acquisition of MedfusionRx, LLC. MedfusionRx is a leading privately-owned specialty pharmacy provider with significant expertise in providing clinical services to over 9,000 patients with complex chronic conditions. MedfusionRx manages approximately $270 million of drug spend annually.

The Apothecary Shops launched a pilot program at all of its specialty pharmacies in seven states to increase treatment success for Hepatitis B and C patients through ongoing contact with patients and their physicians, counseling, depression screening and even injection training.