PHILADELPHIA — The specialty pharmacy market is set to reach $90 billion this year, so it’s clear that managed care organizations have a lot at stake.
That was the overarching theme at a symposium organized by specialty pharmacy provider ACRO Pharmaceutical Services, in conjunction with Armada Health Care, last Thursday at the Hyatt Regency at Penn’s Landing in Philadelphia.
The symposium included presentations by Russel Allinson, CEO and chief clinical officer of specialty pharmacy consulting and analytics company Therigy; and Mesfin Tegenu, president of pharmacy benefit manager PerformRx; as well as a keynote speech by Eric Elliott, president and CEO of PBM Prime Therapeutics; and a panel discussion about various specialty pharmacy and payer issues featuring executives from several payer organizations.
Elliott’s speech focused on healthcare reform and the healthcare environment that will take shape as a result of it. Specifically, Elliott suggested that PBMs and insurers should look at what kind of market will exist after the Patient Protection and Affordable Care Act takes full effect rather than focusing on how to implement reform.
“The thing about healthcare reform is that it’s not yet completely clear what it is,” Elliott said, saying that increased access would be the most visible outcome. The Congressional Budget Office projected that 22 million Americans will be uninsured by 2019 under the healthcare-reform bill, compared with 54 million had the bill failed.
Despite increased access, drug companies will make less money as a result of the bill’s creation of a regulatory approval pathway for biosimilars. “Healthcare reform and the clear pathway created where one didn’t exist before will have a negative impact on brand revenues,” Elliott said.
Following Elliott’s speech, a panel of payer organization executives participated in a question-and-answer session on such issues as specialty drugs and strategies after healthcare reform, limited distribution drugs, health plan-preferred or exclusive specialty pharmacy networks, REMS and biosimilars.