Pharmaceutical balance tipping to specialty side

The new world of targeted, specialized medicines — many of them bioengineered and many of them aimed at smaller and smaller segments of the population — isn’t just on its way. It’s here. And it’s going to radically change the practice of pharmacy.

Here’s an eye-opener: Specialty drugs will likely account for 50% of all drug costs by 2018, up from 28.7% of total prescription drug costs in 2012.

That’s according to two new studies from pharmacy benefit manager Prime Therapeutics and Blue Cross and Blue Shield of Minnesota. As reported in Drug Store News, April 2, the studies were based on pharmacy and medical claims from 1.2 million commercially insured and continuously enrolled members receiving a drug for hepatitis C or rheumatoid arthritis, and looked at cost-of-care trends for the two disease states.

Specialty drugs, said Sumit Dutta, SVP and chief medical officer for pharmacy benefit manager Catamaran Corp., are now “the primary driver of new product development, where you’ve got new therapies for narrower and narrower diseases.” As opposed to old-line drugs like broad-spectrum antibiotics or statins, he added, many of the new medicines are aimed at “a much smaller group of people in a targeted way.”

Still to come, said the physician, is “the promise of individualized therapies and personalized medicine."

“We’re not there yet but we’re moving toward that,” he predicted recently in an interview.

What will that mean for community, institutional and hospital pharmacy? Will pharmacies of the future be like therapeutic boutiques, where individual patients, pharmacists, physicians, nurse practitioners and other clinicians work in a virtual side-by-side setting, connected electronically and applying genomic research and molecular tinkering as they constantly fine-tune dosages and expensive drug formulations for maximum patient benefit?

One thing seems certain: pharmacists will be called on, more and more, to manage expensive and time-consuming specialty drug therapies for patients with serious, complex and chronic conditions. And in the process, they’ll be making a huge beneficial impact on millions of patients whose lives will depend on those medicines and pharmacist interventions.