Specialty Pharmacy Networks

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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

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What is a specialty pharmacy?

Specialty pharmacies were established in direct response to the industry’s need to better procure, store, and dispense specialty drugs, as well as better manage therapy for patients on specialty drugs.

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What services do specialty pharmacies provide?

Specialty pharmacy services are designed for a small, but growing population of patients with relatively complex and chronic diseases that require expensive and challenging drug regimens.

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Specialty Drug Trends

Complex, innovative, and high-priced specialty drugs are entering the United States health care market at a rapid rate.

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What is a specialty pharmacy network?

To maximize the patient benefit of drug treatments, preferred specialty pharmacy networks are used to deliver high-quality, accessible pharmacy services.

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