U.S. spending on specialty prescription drugs continues to rise. In 2014, the U.S. healthcare system spent $373.9 billion on drugs—13.1% more than it did the previous years—reflecting the highest rate of spending growth since 2001. Further, according to a forecast by Express Scripts, specialty drug spending in the U.S. is expected to show a 67% increase in 2015 and a 400% increase by 2020.
This tremendous growth offers significant revenue opportunities for specialty pharmacies. It also presents related challenges, especially for Pharmacy Benefit Managers (PBMs).
Pharmacies must be positioned to scale operations to address the growing demand for specialty drugs. They should develop front-end and back-end processes designed to avoid gaps in patient care, create 24/7 call centers and patient assistance programs, hire the right talent to manage operations, and develop a flexible distribution model that can grow as demand for these drugs grows.
A Unique Alliance
Our alliance was created to provide specialty pharmacies with experienced advisors who will collaborate in real time to help clients align their business goals with their operating and financial strategies. Also critical, we can help specialty pharmacies maintain compliance with state and federal regulatory issues and keep pace with ever-changing PBM manuals. We can also advise them in areas that include securing limited distribution drugs, fighting for inclusion in restricted pharmacy networks, and participating in limited drug distribution.
Specialty pharmacies will have a difficult time achieving growth in the consolidated PBM space without sophisticated guidance to help them navigate demanding PBM compliance with State and Federal Any Willing Provider laws. Our professionals can also help these pharmacies address business scalability as well as specialized placement of specialty pharmacy professionals.
The CohnReznick, Frier Levitt, and the CSI Specialty Group alliance allows us to provide our clients with the right resources at the right time, drawing as needed from across our firms to help clients throughout their business life cycles. By assembling a team of experts proficient in handling a breadth of specialty pharmacy needs, we can help specialty pharmacies and hospital systems overcome their growth challenges and provide superior patient care. Because our firms have worked together across multiple engagements, each member of the alliance is aware of the others’ operating methods and requirements. This creates efficiencies designed to enhance the quality, timeliness, and value of our services.