For decades now, patients and care teams managing complex and chronic conditions have had no choice but to accept some of the healthcare industry’s biggest flaws: fragmented communications and information silos that hinder care coordination, add administrative burden and elevate costs. These silos can cause patients to become less engaged in their own care, to the detriment of their experiences and outcomes. Perhaps no one feels this more acutely than specialty care patients. Being diagnosed with a chronic, complex or rare condition is stressful in and of itself. When these patients then encounter barriers that inhibit their access to care, it can lead to medication non-adherence and poor health outcomes.
No single part of the system can solve these problems by itself. But strong cross-industry partnerships have transformative potential. And specialty pharmacies—which focus on dispensing high-touch medications to people with serious health conditions—have a key role to play in these partnerships. When providers and payers team up with specialty pharmacies, their joint efforts can enable access to comprehensive, integrated care delivered through a holistic, patient-centric approach. This alliance can empower stakeholders across the healthcare industry to break down longstanding barriers and boost the effectiveness and affordability of care.
The rise of specialty pharmacy
The chronic disease burden felt by patient populations across the United States is growing. Demographic data show that more than 60% of American adults live with a condition that requires specialized medications or therapeutics, such as cancer, multiple sclerosis, cystic fibrosis, rheumatoid arthritis, organ transplantation and many more. At least 40% suffer from two or more of these conditions, numbers that will only increase as the population ages. By 2030, one in every five Americans will be over the age of 65, a group that disproportionately bears the burden of chronic disease, with 85% having been diagnosed with at least one such condition.
These patients typically have complex care needs. Often, they must navigate multiple provider relationships, repeatedly obtain prior authorizations or verify benefits for access to procedures and medications, and navigate financial barriers since their care is expensive. Of the $4.5 trillion spent on healthcare each year in the U.S., the cost of caring for patients with chronic disease accounts for about 90%.
Not only do these patients require specialized care, but they also need access to a growing number of medications with highly detailed handling, administration or storage requirements. These drugs are often distributed only through limited or restrictive networks, and their use involves more in-depth clinical monitoring with higher numbers of patient touchpoints than conventional medicines. Many of these newer specialized treatments—such as cell and gene therapies for cancer—are testing the limits of science and radically improving outcomes or even curing what were once considered terminal diseases, but they tend to be expensive.
With growing numbers of these therapies entering the market each year, and continuing expansion of indications for existing specialty medicines, demand for services from pharmacies able to fill these prescriptions—and meet the care needs of the patients taking them—is on the rise. Fewer than 30 specialty drugs were available in the 1990s, but by 2023, they accounted for 80% of the novel treatments approved by the FDA, and represented 75% of the drugs under development the following year.
Revolutionizing care coordination to put the patient first
When patients with complex, chronic, and rare conditions obtain their prescriptions from a specialty pharmacy, they gain access to a coordinated care approach that extends far beyond the pharmacy counter. For instance, Walgreens Specialty Pharmacy, the largest specialty pharmacy in the U.S. unaffiliated with a pharmacy benefits manager (PBM), enjoys enormous partnership flexibility across the entire healthcare ecosystem. This makes it possible for Walgreens to join forces with any payer, provider or pharmaceutical manufacturer, opening the door to effective care coordination and seamless treatment access for patients.
“Pharmacists, physicians and other care team members don’t always communicate well or often,” says Tracey James, Chief Operating Officer of Walgreens Specialty Pharmacy. “Specialty pharmacists interact with patients at least every month, if not more often. They check in on how the treatment journey is going. They’re available to answer questions. Many patients connect with specialty pharmacists more regularly than they do with specialists or prescribers. Because of this, the specialty pharmacist can be the first one to notice issues—like falls, missed doses or debilitating side effects. They’re in the perfect position to share this information with providers and health plans. It’s a first line of defense against fragmented care.”
When it comes to improving care coordination, today’s specialty pharmacies are leading the charge. They’re delivering tailored, condition-specific support to help patients better understand and manage complex diseases. This proactive approach includes adherence counseling as well as assistance from pharmacists, nurses and registered nutritionists and dieticians. It harnesses the power of the entire healthcare team—including communication with providers—to optimize treatment adherence and boost outcomes.
Specialty pharmacies can also partner with commercial insurers and other payers to help with cost management. Walgreens works to simplify and expedite the prior authorization process, reducing administrative burden and accelerating patient access to critical treatments. Walgreens also maintains a longstanding commitment to making therapies affordable and accessible. Specialty medications are often expensive, and financial assistance programs can make all the difference in enabling access to much-needed treatments. In 2023, Walgreens secured $608 million in financial assistance for eligible patients.
Making specialty pharmacy care accessible for everyone
As specialized therapies come to occupy an ever-larger place in the treatment landscape, it will be increasingly important to make them available in communities across the country. With an extensive network of more than 275 community and central specialty pharmacy locations in the U.S., Walgreens has the nationwide reach to make sure that patients get the medications they need. Walgreens also has 8,500 traditional retail stores, offering another point of access for patients who want to pick up their medications in their own neighborhood, since specialty pharmacy medications can be mailed to a local Walgreens (or the patient’s home or workplace).
When time is of the essence, Walgreens Specialty Pharmacy comes through for patients, with an average prescription turnaround time of two days. This speed is crucial for those who need to initiate treatment without delay.
“Walgreens has spent decades earning the trust of local communities and building strong relationships with prescribers,” says James. “By putting the patient at the center of everything they do, Walgreens is able to deliver innovative, flexible care that breaks down barriers and supports patients throughout every stage of their journey.”
These close relationships with patients—along with the ability to communicate with every member of the care team—mean that specialty pharmacies can serve as the glue that holds an otherwise fragmented and siloed care ecosystem together. In a world where better care coordination enables better patient outcomes, the worth of this connection is beyond measure.
To learn more about Walgreens Specialty Pharmacy, visit us online.
