The Asembia (formerly known as Armada) Specialty Pharmacy Summit is fast becoming the pharmaceutical industry’s most important meeting. This year’s Las Vegas show boasted a record attendance of nearly 5,000 pharmaceutical manufacturers, specialty pharmacies, payers, and solution vendors. As new therapies trend more and more towards high price, niche, or patient-tailored treatments often requiring special handling, this surge of interest in all things specialty pharmacy is no surprise.

The enormous rise in specialty brand launches has changed the traditional channel distribution model. Life sciences distribution channels have become much more complicated, and this has led to an increase in the number and complexity of data sources available related to distribution. Traditional syndicated data sources are ill-equipped to provide the breadth of information needed to make informed decisions about channel management.

Trends in Specialty Pharmacy

Several of the themes that emerged from the Asembia educational sessions have profound implications for the healthcare data ecosystem:

• Innovative, enterprising specialty pharmacy startups abound, all clamoring to understand how they can obtain accreditation with one of the specialty pharmacy credentialing bodies. In this new world, hundreds of specialty pharmacies are producing valuable data, but there is currently no set of uniform standards informing how those data should be structured, making it challenging to master and produce analytics from them.
• Integrated Delivery Networks are moving to provide a seamless patient experience by integrating all services and data relevant to the patient’s journey. Many, like Johns Hopkins Medicine, are even establishing their own specialty pharmacies. Coupled with the myriad of payer-specific considerations, it appears regional dynamics are becoming an increasingly important part of channel design strategy.
• Disruptive companies like AdhereTech are testing smart pill bottles that monitor patient adherence, alerting both patients and specialty pharmacy case management staff when an intervention may be needed. Beyond driving compliance on a case-by-case basis, new technologies like this will also lead to an explosion of valuable metadata that can be used to analyze patient behavior and obstacles to adherence or persistence. With an estimated $200 billion in negative health outcomes associated with lack of adherence,¹ data sources like these will be in high demand. However, few healthcare-related businesses are equipped to ingest, transform, match, cleanse, store, integrate, or analyze these types of data feeds, which will tend to be much higher volume than the types of datasets currently used by manufacturers.
• Disease-specific social media platforms are becoming the key source of information sharing and support among patient populations. These sites are crucial in understanding the patient-centric journey for a specialty brand. These platforms produce a wealth of information that can enable brand managers to better understand patient access, but this information is largely unstructured. Unstructured data is incredibly challenging to manage, analyze, or integrate with other data sources.
• Presently, only about 14% of plans report participating in outcomes-based contracting, but this number is expected to grow substantially in the next few years.² Manufacturers will need a strategy to reach agreement on outcomes metrics, validate the data sources supporting those metrics, and navigate potential regulatory efforts. Obtaining accurate and timely data will clearly be paramount to any outcomes-based reimbursement model. Today, most health plans view reporting of outcomes and expenditures data from speciality pharmacies as highly valuable, yet they are largely unhappy with what they currently receive.²

Issues to Consider in Specialty Channel Design

Against this backdrop, it is clear that designing a channel strategy for a specialty brand has become extremely challenging. Often, distribution networks need to be adjusted post-launch due to factors like sub-par specialty pharmacy performance, payer considerations, additional product labeling, growing or changing patient populations, and brand competition. It is vital to continually measure specialty pharmacy performance after launch and to determine the right metrics to use for these measures.

Most manufacturers have opted for a limited distribution model, preferring greater control and improved visibility compared to an open distribution model.³ However, closed distribution networks will not work for many brands. Strategies for these brands will need to integrate across a sizable network of pharmacies, which means manufacturers will need to build account management and disease management processes that scale. These new approaches will be challenging to manage and highly disruptive to traditional distribution channels.

Increasingly complex contracting strategies and channel design and management processes will require input from an ever greater number of disparate data sources, all with non-standardized content. Therefore, specialty brand manufacturers will need to ensure they have access to the right platforms, master data management expertise, and data quality assurance processes to meet all of these challenges.

¹ Blue Fin Group presentation at Asembia Summit 2016.
² EMD Serono presentation at Asembia Summit 2016.
³ InVentiv Health presentation at Asembia Summit 2016.