Specialty Pharmacy Networks

Return to Policy & Issues

Preferred specialty pharmacy networks are used to deliver high-quality, accessible pharmacy services and maximize the patient benefit of drug treatments. By contracting with select pharmacies, PBMs can ensure consistent care management across all pharmacies in the preferred network while simultaneously promoting affordability in the specialty channel.

Payers rely on PBMs to identify the highest-quality and most cost-efficient specialty pharmacies. With the proliferation of pharmacies now involved in the acquisition and distribution of specialty products, PBMs rely on quality standards and metrics to ensure that the specialty pharmacies they contract with offer the highest quality of care in the industry.

By contracting with preferred specialty pharmacies, plan sponsors have the potential to:

  • Improve patient adherence
  • Improve clinical outcomes
  • Reduce inappropriate utilization
  • Reduce product waste
  • Achieve lower unit costs through effective formulary management
  • Negotiate better discounts from manufacturers
  • Reduce non-drug medical care costs

Research

Press Releases

Additional Resources