Health Systems Get Into Specialty Pharmacies In Effort To Lower Costs Of Priciest Drugs

Medications for autoimmune disease, cancer and hepatitis are some of the biggest drivers of high pharmaceutical costs in the U.S. They’re called specialty drugs, and there’s some debate around the best way to get them to patients.

Dignity Health is the latest hospital system to set up a “specialty pharmacy” — businesses dispensing complex medications that basic pharmacies generally can’t give out. Patients often get the drugs now through their hospital pharmacies, but additional steps and approvals can be a challenge even for them.

Specialty pharmacies can be physical locations or direct mail services. Dignity launched its specialty pharmacy in Arizona and is expanding mail service to the Sacramento area this spring.

Peggy Sanborn, senior vice president of strategic partnerships for Dignity’s parent company CommonSpirit Health, says health systems are able to negotiate directly with drugmakers instead of going through a middleman, which cuts down on costs.

It also allows the health system to oversee the patient’s drug treatment from start to finish.

“To manage a patient, and manage the overall spend, it does make more sense,” Sanborn said. “We intend to extend the program to as many places as it looks like it will be beneficial. It’s personalizing the care for patients with acute and chronic conditions.”

The California Hospital Association says there’s growing interest among members about specialty pharmacies.

“If we’re able to provide drugs at a lower cost and have better access, and provide better care coordination to the patients ... that’s what we want to provide,” said BJ Bartleson, the association’s vice president of nursing and clinical services.

Some groups are concerned that separating out specialty drugs will make it harder for regular pharmacists to stay apprised of a patient’s whole treatment plan.

About half of U.S. hospitals with more than 600 beds have a specialty pharmacy, according to a survey from the American Society of Health-System Pharmacists.

Dignity Health already has retail pharmacy operations dispensing non-specialty prescription drugs. The recent expansion is in partnership with Shields Health Solutions, a company that helps health systems build specialty pharmacies.