June 3, 2014

Federal and state policymakers should avoid policies that undermine specialty pharmacies’ expertise in dispensing costly specialty medications used to treat serious conditions such as cancer, rheumatoid arthritis, and multiple sclerosis, the National Center for Policy Analysis (NCPA) says in a new report, “Specialty Drugs and Pharmacies.” The report points out that “specialty drugs require a level of experience and expertise that most drugstores simply do not possess.”

“NCPA’s report on specialty drugs highlights the need for policies that allow specialty pharmacies to do what they do best: deliver these unique medications safely to patients,” said Mark Merritt, President and CEO of the Pharmaceutical Care Management Association (PCMA). “It’s wrong to make employer and union health plans contract with drugstores that may not be qualified to dispense complex specialty medicines.”

According to the NCPA report:

  • Specialty Pharmacies Have Expertise at Handling Expensive, Fragile Medications. “Specialty drugs require a level of experience and expertise that most drugstores simply do not possess. Stocking and dispensing specialty drugs often involves handling biological agents that are very fragile — often requiring complex distribution channels. For instance, many biological agents require sophisticated logistical planning — including climate-controlled shipping and meticulous storage — with specific protocols and documentation.”
  • Specialty Pharmacies Better Equipped Than Drugstores to Ensure Patient Care. “Specialty pharmacies are more highly involved in patient care than drugstores that merely dispense drugs. Patients who receive specialty drugs and biological agents require extensive monitoring, risk evaluation, mitigation strategies for side effects and diagnostic support by a physician.”
  • Regulations Restricting Pharmacy Networks Weaken Patient Safety. “Although these regulations supposedly benefit consumers and promote competition, they actually weaken health plans’ ability to safely and efficiently manage prescription drug benefits. Tightly controlled pharmacy networks also allow better tracking by manufacturers of drugs that require specific or complex dosing and lab monitoring, which the FDA sometimes requires as a condition of drug approval. FDA monitoring requirements favor tightly controlled networks for safety reasons.”
  • Laws Restricting Pharmacy Networks Increase Costs. “State and federal laws can interfere with negotiations between drug plans, drug makers and pharmacies. Such consumer protection laws are actually costly to taxpayers, employers and patients.”

A national survey of physicians who prescribe specialty medications found that just 5% believe that all drugstores “have the expertise and capability to provide the different types of specialty medications to patients.” Some state legislatures are considering new mandates that would force employers to contract with any drugstore that wants to dispense complex specialty medications, regardless of its qualifications. This has been a top legislative priority of the drugstore lobby.

Specialty Drugs and Pharmacies Press Release