By Brenda Hawkes, Patient Advocacy Manager, and Justine Dolorfino, Social Media Specialist & Communications at Diplomat Specialty Pharmacy

If you have a prescription to treat a serious disease or condition such as HIV, psoriasis, or cancer, chances are that you get your medications through a specialty pharmacy. You may have wondered what the ‘specialty’ in the title means and why that makes a difference.  We can help explain that here.

What Is A Specialty Pharmacy?

Specialty pharmacy is a branch of pharmacy care that helps people with special and often long-term needs. These people include those with conditions like cancer, multiple sclerosis or HIV, as well as people with fertility issues or who’ve received a transplant. Specialty pharmacy care allows people to continue leading lives outside a hospital, with better outcomes and lower overall costs.

To treat these diseases and conditions, specialty pharmacies focus on specialty and limited-distribution drugs, which require special handling, storage, and dosing.  These treatments are often expensive, and typically, they’re offered only at specialty

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Biosimilars are defined as “similar versions of an existing biological medicine by a different manufacturer.” Biosimilars may be used to treat difficult-to-manage conditions including rheumatoid arthritis, multiple sclerosis, chronic pain, HIV and cancer, among other conditions. Because they are more complex and more difficult to manufacture than other pharmaceuticals, rigid compliance to regulations and quality control are crucial to avoid contamination and drug shortages. Their complexity also means that they are more expensive for the patient.

A recent article by NBC News suggests that “the number of patients who could benefit from these more sophisticated therapies will only continue to grow, in some cases by 15% annually.” But how will we afford them?

Changes are afoot in many health insurance plans, and some new rules state that any cost-savings must be weighed against severe health consequences, particularly where obtaining prior approval (an often lengthy process) or “step therapy” where a number of cheaper drugs are tried before moving on to more expensive ones.

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Healthcare costs continue to be a concern, despite efforts underway to reduce them through healthcare reform initiatives.  One area, in particular, is worrying patients and physicians alike: specialty drugs or biologics. An article in Workforce Management reports that specialty drugs “make up about 17% of employers’ total drug costs, even though just 1% of the workforce takes them.”  Reuters reports that “approximately 57 million Americans rely on specialty drugs,” with the average prescription costing $1,766.00 in 2011.

“Specialty drugs are high-cost drugs used to treat complex or rare conditions, such as multiple sclerosis, rheumatoid arthritis, hepatitis C and hemophilia. The drugs are often self-injected or administered in a physician’s office or through home health services,” according to Wellmark. Specialty pharmacies specialize in the delivery and clinical management of specialty drugs.  It is reported that the average cost per specialty medication is $2,000.00 per month,

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