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Specialty drugs shake up field of Rx players

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The rapid growth of the specialty pharmacy sector, fueled by high-priced specialty drugs, remains one of the leading story lines in the pharmacy industry.

Adam Fein_Drug Channels Institute

Adam Fein

Compared with the retail pharmacy arena, the field of players in the specialty Rx market has yet to shake out. But pharmaceutical supply chain and economics expert Adam Fein, CEO of the Drug Channels Institute, notes that specialty’s imprint on the overall prescription marketplace continues to get bigger.

“PBM-owned and insurer-owned specialty and mail pharmacies constitute six of the country’s largest 15 pharmacies. The largest PBMs and insurers account for 60% of specialty dispensing revenues,” observed Fein, author of the 2017 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers study, released on Tuesday.

The report pegs total prescription dispensing revenues from specialty medications at retail, mail, long-term care and specialty pharmacies at $115 billion for 2016.

“Retail pharmacies account for a majority of the industry’s dispensed prescriptions but a decreasing share of the industry’s revenues,” Fein stated. “Their prescription profits will suffer as the generic market matures.”

CVS Health, Walgreens Boots Alliance, Express Scripts, Walmart, Rite Aid and OptumRx (UnitedHealthcare) represent the “top tier” of dispensing pharmacies and, combined, drove about 62% of U.S. prescription dispensing revenue last year, Fein wrote in a recent blog post.

The rest of his list of the top 15 U.S. dispensing pharmacies includes food/mass retailers, health insurers, a PBM, a specialty pharmacy and a long-term care pharmacy: Kroger Co., Albertsons Cos., Humana (Pharmacy Solutions), Prime Therapeutics, Diplomat Pharmacy, Cigna, Costco Wholesale Corp., Ahold USA and PharMerica.

“The growth of specialty drugs is reshaping the pharmacy and PBM industries,” Fein said in the posting.


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