I conceptually agree with this for a lot of disease states, and definitely agree that your standard retail pharmacy can fill your Hep C prescriptions just as easy as Accredo or Caremark specialty can - there's nothing to that. But there are plenty of disease states that do require specially trained pharmacists. I work in a specialized location (not officially a specialty pharmacy, but the only difference is the title and my insurance contracts), and I sure as hell don't want most of my peers dealing with orders from my disease state, because as students we did not learn about the disease state in school, so I don't want someone spouting off bad information because they weren't knowledgable about it. Or dispensing a medication that costs 10K and needs to be done via infusion, but failing to make sure the patient has the means to get it infused. In addition, a *good* specialty pharmacy will go through and get patients enrolled in financial assistance programs like PAN and the like, that will remove barriers to adherence.Boring as f***. Worked in an Upper East Side specialty pharmacy doing over $75 million in revenue a year, and it was terribly boring. I was mostly hearing the techs call the offices and insurances for prior authorizations, and they handled everything. I did it myself too, but it wasn't anything to be excited about. Paid $65/hr on the books, work 4 days week for 10 hours each day Monday to Thursday. I don't know what the jobs outlook is.
Working there was just like working in a retail pharmacy. It was another example of how there is nothing special about specialty pharmacies. Patients had profiles with 1 drug in them, and their pharmacy at home will have the other 20 something drugs they are taking. It was more dangerous to dispense drugs in the specialty pharmacy than it is at a patient's regular community pharmacy. There was nothing special about any of the drugs either. Either they were pills, or they were injections kept in a refrigerator. A delivery driver would deliver it to the residence in NYC, or FedEx would ship it throughout the country.
So why do these specialty pharmacies still exist? What is so special about them? Adherence? No. Storage requirements? No. Knowledgeable pharmacists who know the particular disease state? No. More patient specific care? No.
Nothing. The only thing different than regular retail pharmacy is we did the prior authorizations for the doctors and took that off their shoulders, and since reimbursement was better, we didn't fill as many scripts. Instead of trying to fill 500 scripts a day, all we had to do was fill 30 to 90 a day depending on the day.
There is no reason a patient's regular community pharmacy cannot dispense the inappropriately named "specialty" drugs. There is nothing special.