“We project that the pharmacy industry’s revenues will exceed $483 billion in 2020,” stated Fein, author of the 2016 Economic Report on Retail, Mail, and Specialty Pharmacies study, released on Tuesday. “Expensive specialty medications that treat such illnesses as cancer, multiple sclerosis, and hepatitis C will account for almost half of the pharmacy industry’s revenues by 2020.”
What’s more, Fein notes in the study, PBMs and third-party payers are regulating patient access to products and pharmacies. “To control costs and manage access, PBMs and health plans limit the number of pharmacies available to a beneficiary,” he explains. “Payers also determine pharmacy benefit designs, which increasingly shift specialty drug costs to consumers in the form of high copayments and coinsurance.”
The study, too, examines key health care trends impacting the pharmacy arena, along with such factors as health care reform, biosimilars, the 340B drug pricing program, pharmacy consolidation and manufacturer channel strategies.
“Competition is forcing pharmacies to reduce their prescription profit margins,” according to Fein, who’s also president of Pembroke Consulting. “Consequently, pharmacies are seeking new reimbursement models and looking to be compensated for healthcare services.”
In the report, the Drug Channels Institute pegs overall sales of retail, mail and specialty pharmacies last year at $364.1 billion, a 12.1% year-over-year gain, with CVS Health, Walgreens Boots Alliance, Express Scripts, Walmart, Rite Aid and OptumRx representing approximately 64% of U.S. prescription dispensing revenue. Check out Drug Channels’ list of the top 15 biggest U.S. pharmacies by Rx revenue in this posting last week.