Specialty Pharmacy Trends Report: Asthma

Asthma is a chronic lung disease that inflames and narrows the airways, causing recurring periods of wheezing, chest tightening, shortness of breath, and coughing. According to the Centers for Disease Control and Prevention, approximately 25 million people in the United States have asthma, with this number increasing each year. Additionally, medical expenses associated with asthma cost the nation $50 billion annually. This value increases by $6 billion annually if the costs resulting from absenteeism in school and work among children and adults and early deaths associated with asthma are included.

Though incurable, individuals with asthma can manage their symptoms through the use of medications, such as inhaled corticosteroids, and by avoiding triggers that worsen conditions, such as exposure to cigarette smoke, air pollution, and allergens. Current trends in specialty pharmacy for asthma include an in-office subcutaneous injectable used for the treatment of patients with moderate-to-severe allergic asthma induced by year-round allergens.

When the survey respondents were asked if they are involved with reporting adherence and/or compliance on the use of asthma medications obtained through specialty pharmacy, 53.7% said “never,” 22.22% said “rarely,” and 16.67% said “occasionally” (Figure 1).

The majority of survey participants (61.11%) said 0% to 25% is the percentage of their specialty pharmaceuticals for asthma treatment that require inoffice administration of the drug (Figure 2).

The survey respondents were relatively split when asked if they collect patient report outcomes data for asthma, with 55.56% who said “no,” and 44.44% who said “yes” (Figure 3).

Of the survey respondents who indicated that they collect patient report outcomes data for asthma, the majority (25.93%) used telephone outreach, while 9.26% used patient visits (face-to-face) for data collection (Figure 4).

When asked what the primary focus of their patient report outcomes data is, 25.93% of the survey
participants said quality of life, while 11.11% said side effects (Figure 5).

The survey respondents were asked what percentage of their asthma patients have comorbid conditions, and 37.04% said they were unsure, while 22.22% said 26% to 50% of their patients have
comorbidities (Figure 6).

Specialty pharmacy is a burgeoning field that continues to be of importance for managed care professionals. With the rates of chronic, high-cost conditions increasing, payers are eager to find ways to diffuse costs, while also providing patients with the best care possible. First Report Managed Care partnered with the National Association of Specialty Pharmacy to put together this Specialty Pharmacy Trends Report.

The information for this trends report was generated through a comprehensive survey developed via the collaborative efforts of an Advisory Panel of key thought leaders and the First Report Managed
Care editorial staff. This survey was then sent to a diverse pool of specialty pharmacy professionals. This is part 1 of a 3-part series we bring to you on the climate of specialty pharmacy as it relates to the managed markets. We hope that you find the information presented to be practical, informative, and compelling. We hope the survey results serve as a resource you can use in making future management decisions.

Survey Participant Demographics

Key thought leaders in the field of specialty pharmacy have provided the information collected in this Specialty Pharmacy Trends Report series. The following are the demographic responses, providing a snapshot of the survey participants and the organizations for which they are affiliated.

The Northeast is home to most of the survey participants (33.93%), while 28.57% of participants are in the Midwest, 10.71% in the Southeast, 10.71% in the Pacific, 10.7% in National regions, 3.57% in the Mountain region, and 1.79% said “not applicable.”

The majority of the survey respondents (60.71%) have a PharmD degree, while 39.29% have a BS in
Pharmacy, 17.86% have an MBA, 10.71% have an MS, and 5.36% have a PhD. A significant majority of survey participants (53.57%) have an RPh certification, while 17.86% have a BCPS, and 12.5% have a CSP.

When asked how long they have been in the specialty pharmacy field, 35.71% of survey participants said 0 to 5 years, while 28.57% said 11 to 20 years, and 26.79% said 6 to 10 years.

Mail-order specialty pharmacy is the primary facility of work for 23.21% of the survey participants. An additional 16.07% said their primary facility of work is an academic institution (not a university hospital), another 16.07% said a managed care organization, 14.29% said a retail specialty pharmacy,
and 10.71% said a consulting firm.

When asked what type of specialty pharmacy they are involved with, 26.79% of the survey respondents said independently owned (nonretail) and another 26.79% said pharmacy benefits manager. Another 16.07% of the survey respondents are involved with a health plan-owned specialty pharmacy and 14.29% are retail pharmacy owned.

Most of the survey respondents (39.29%) reported that they have 1% to 25% of patient interaction time on a monthly basis, while 28.57% said their role does not currently involve patient interaction.

When the survey participants were asked to select the top 5 therapeutic categories with which they are
most involved, and with the option to select up to 5 areas, the results were the following:
     • Oncology (69.64%)
     • Rheumatoid arthritis (67.86%)
     • Hepatitis C (64.29%)
     • Multiple sclerosis (50%)
     • Diabetes (37.5%)
     • Crohn’s disease (35.71%)
     • Psoriasis/Psoriatic arthritis (35.71%)
     • HIV/AIDS (25%)
     • Hemophilia (23.21%)
     • Immunoglobulins (12.5%)
     • Cystic fibrosis (8.93%)
     • Hereditary angioedema (5.36%)
     • Gout (3.57%)
     • Infertility (1.79%)