Specialty pharmacies deal with complex medications and treatment regimens for cancer, hepatitis C, organ transplants, HIV and other conditions, and involve one-on-one patient support services to manage adherence, side effects, dosage changes and refills.
Hy-Vee recently announced its intent to expand its specialty pharmacy business by acquiring Amber Pharmacy, its partner in Hy-Vee Pharmacy Solutions since 2010.
Dispensing specialty drugs and offering related services helps food retailers retain profitable shoppers, said Jeff Pepperworth, president of Inmar Healthcare Network.
“Loyalty can be created, patient/consumer shopper experiences can be made,” he said. “Think of it as food pairing that involves the consumer’s health conditions.”
Employee-owned Hy-Vee founded Hy-Vee Pharmacy Solutions four years ago to more economically serve the specialty pharmacy needs of its employees. Since then, it’s expanded services to customers.
“The partnership between Hy-Vee and Amber Pharmacy has been very successful over the last four years,” said Randy Edeker, chairman, president and CEO of Hy-Vee. “Specialty pharmacy continues to experience tremendous growth.”
Indeed, in 1990 there were 10 specialty drugs vs. the nearly 300 agents that met the definition of specialty drug in 2012, according to Hy-Vee.
That number will climb, according to Inmar, which projects that more than half of all pharmacy spending in the U.S. will be in the specialty pharmacy sector by 2017.
Hy-Vee’s acquisition comes months after Giant Eagle, Pittsburgh, acquired Rx21 Specialty Pharmacy as part of a move to allow it to service hepatitis C and organ transplant patients under Giant Eagle Specialty Pharmacy.
“We greatly value the expertise gained with the new acquisition of Rx21, particularly at a time when two significant new hepatitis C treatments are becoming available,” said Brett Merrell, SVP of health and wellness at Giant Eagle, in a statement, last December.
Merrel is referring to the FDA’s approval of Olysio and sofosbuvir as treatments for hepatitis C, a viral condition that causes inflammation of the liver and can lead to permanent liver damage, liver cancer, liver failure and cirrhosis, according to the CDC.
Patients who have prescriptions for these and other specialty drugs filled at Giant Eagle, have access to a dedicated team of professionals whose focus is to reach out to patients regularly through their treatment; nutritional advice and personalized meal planning from a store dietitian; assistance with prior authorizations and insurance verification; and 24-hour access to a pharmacist.
Such support services are necessary, given the cost and complexity of these drugs, explained Kathleen Jaeger, SVP of pharmacy care and patient advocacy for the National Association of Chain Drug Stores.
“[Specialty pharmacists] provide as much compliance and education as they can for these patients,” she said. “They need it to help them get through these complex regimes to make sure that they don’t have adverse events from noncompliance and also so they don’t have waste because these products can be so, so expensive.”
Community pharmacies are particularly well-suited to meet patients’ needs given their proximity to home, she added.
“To have someone in your community that is able to help you with your HIV or cancer, and really be able to explain to you this complex regime, is phenomenal, because these patients are taking anywhere from three to eight medications at a time,” Jaeger said.
Kroger has also gained a foothold in the space. In 2012, the retailer merged with specialty pharmacy Axium Pharmacy Holdings.
“The combination of Axium’s expertise and Kroger’s 1,950 pharmacy locations, 91 Little Clinic locations, and pharmacists who provide health coaching, biometric screening and other wellness services will deliver positive health outcomes for our patients,” said Lincoln Lutz, Kroger’s VP of corporate pharmacy, when the deal was announced.
Retail pharmacies are not just entering specialty pharmacy, but honing their ability to cater to specific patients by specializing in medications for certain diseases.
“Many retailers are making decisions on which specialty disease states to service in-store,” Pepperworth said. “Giant Eagle’s purchase of Rx21 allows it to focus on hep C and organ transplant, which are common specialty disease states that have a heavy flow of fulfillment at retail. Similarly, Kroger acted in specialty to allow it to focus on diabetes.”