About a year after the U.S. stock markets bottomed out, many industries are still in a state of uncertainty about their futures. But while specialty pharmacies and home infusion companies have been impacted by the economic downturn, Suzette DiMascio, president and CEO of Career Solutions International (CSI), tells SPN she is seeing signs of life in these industries. She also spoke about other trends in these areas, including health plan hesitancy to make any specialty pharmacy changes because of the uncertainty with pending health care reform and the issue of biosimilars. Her firm partners with organizations in search of talent in the specialty pharmacy, mail order, PBM, managed care and biotech manufacturer arenas, as well as with key consultants and venture-capital firms.

According to DiMascio, specialty pharmacies have upped their hiring activity over the past eight months or so, at a rate not seen since 2005-2006. Companies also are looking for employees who have more detailed experi- ence in therapeutic or disease management classifica- tions, such as hemophilia, rather than people who have a broader skill set.
One misperception she says she sees often among companies looking to hire people is that “the market is full of people; therefore, I shouldn’t have any problem hiring.” While this may be accurate if a company is look- ing for lower-level employees, when “you’re dealing with people in managed markets with a disease em- phasis such as hemophilia or oral oncology, that person is going to be employed already,” she says. That, com- pounded by “uncertainty in the marketplace,” means a person is unlikely to make a job change unless there is a good reason to, so a company will need to make a pretty sweet offer to bring him or her onboard, and do so in a timely fashion, she explains. However, DiMascio says she has been receiving an increased amount of job queries from employees in one particular sector — pharmaceuti- cal manufacturers. These employees, she says, are “not real high on the future of pharma.”

New Firms Are Entering Market Almost Monthly

Although the competencies required to start up a specialty pharmacy or home infusion company are much more detailed than those required in some other health care areas, such as hospice (SPN 4/09, p. 5), there are defi- nitely people undertaking this effort, with many smaller companies coming onto the market on almost a monthly basis, she says.
Because many specialty pharmacies and home infu- sion firms are of a relatively small size, they are “under the radar of venture firms,” DiMascio contends. Venture-

capital activity has “definitely picked up over the last four months,” she adds. And these companies are defi- nitely “looking for acquisitions.”
According to DiMascio, it doesn’t matter as much when it comes to getting managed care contracts whether a specialty pharmacy is a smaller size or larger, though. If a specialty pharmacy has someone “who knows the managed markets and can get contracts,” that’s key to its success, she maintains, as is having strong senior manage- ment. In addition, “There is always the opportunity for someone to get a contract with a managed care organiza- tion if there is a hiccup with another specialty pharmacy provider,” maintains DiMascio.

“Payers are not going to change their PBMs, mail or- der or specialty pharmacy partners as often as they may have done in the past. Pending changes in reimburse- ment, health care reform and biosimilars are high on their list of concerns,” says DiMascio. “But unless a ser- vice component is missing, many payers will opt to stay with their current pharmacy providers until the times are more certain.”