Specialty Pharma: At a Glance
- The specialty pharmaceuticals market grew from $92 billion in 2023 to $129 billion in 2024—and it is expected to continue rising at a CAGR of 39.8%, nearly reaching $1 trillion by 2030.
- The growth has been spurred by a steady influx of high-cost therapies targeting small patient populations with complex conditions, such as cancer, autoimmune diseases, and rare genetic disorders.
- In 2024, the FDA approved a record number of specialty medications, including several gene therapies and biologics.
Source: Definitive Healthcare
The following case study illustrates how a leading pharmaceutical company utilized longitudinal data from specialty pharmacy providers (SPPs) and retail channels to evaluate the return on investment (ROI) of patient adherence initiatives. The analysis centered on whether SPP-driven services, including patient counseling and follow-up, enhanced adherence and yielded measurable financial benefits.
Key tactics and rationale
Pharmaceutical manufacturers, particularly those marketing injectable or complex therapies, often utilize SPPs to enhance patient compliance and persistence. SPPs provide tailored support, including:
- Patient counseling on medication administration
- Regular follow-ups to address side effects or questions
- Assistance with prescription renewals
Example 1
A manufacturer of a biologic for rheumatoid arthritis distributed its product through both specialty SPPs and traditional retail pharmacies. The company sought to determine whether SPP services led to improved patient outcomes and justified further investment.
Comparative analysis: Compliance and persistence
The organization compared compliance and persistence metrics for its products across both channels:
- Compliance was measured over 360 days using the Medication Possession Ratio (MPR), an industry standard.
- Persistence was defined as the percentage of patients remaining on therapy after one year, allowing for gaps of less than 60 days.
Results
Compliance: SPP channels achieved 7%-10% higher than retail pharmacies. For example, if the retail channel had a 75% MPR, the SPP channel ranged from 82%-85%.
Persistence: After one year, 50%–60% of SPP patients remained on therapy compared to 30%–40% in the retail channel—a difference of more than 20%.
Example 2
For a multiple sclerosis injectable, 58% of patients using an SPP remained adherent after a year, versus 37% for those using retail pharmacies.
Attribution of results
The improved outcomes in the SPP channel are likely due to:
- The convenience and advantages of automatic prescription renewals
- Proactive patient education and support from SPP nursing staff
While other factors may contribute, the identical drugs and dosage forms across channels support the inference that SPP services are the key differentiator.
Financial impact
With the average monthly treatment cost at $2,700, the annual incremental revenue per patient in the SPP channel was:
- $8,717 higher for one product
- $9,055 higher for another
Example calculation: If 2,000 patients shift from retail to SPP, the additional annual revenue for a single product could exceed $17 million.
Strategic implications for manufacturers
Drugmakers can drive significant improvements by:
- Quantifying the business impact of non-compliance and non-persistence.
- Investigating reasons for non-adherence through patient feedback insights and claims data.
- Continuously monitoring and evaluating the effectiveness of support programs.
- Prioritizing investments in channels and services that deliver the highest ROI.
Example actions:
- Launching a nurse-led adherence program for oncology patients and tracking persistence rates quarterly.
- Using SPP data to identify drop-off points and proactively intervene with at-risk patients.
Final thoughts
Access to detailed, longitudinal data from SPPs and retail pharmacies enables manufacturers to evaluate and rigorously optimize adherence programs for specialty pharmaceuticals. By focusing resources on the most effective interventions, companies can maximize both patient outcomes and financial returns—a critical advantage in today’s high-cost specialty drug landscape.
Partha Anbil is Senior Advisor to NextGen Invent Corporation
Disclaimer: The views expressed in the article are those of the author and not of the organization he represents.
