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The Insider’s Guide to Establishing a Successful Specialty Pharmacy

Today, specialty pharmacies are one of the fastest-growing sectors of the healthcare industry.

According to a Drugs Channels Institute Report, the specialty accreditation shot up 280% from 381 to 1069.

Research by IQVIA observed that the spending on specialty drugs has doubled over the year.

What is a Specialty Pharmacy?

A pharmacy that largely or solely provides specialty medicines or medicines for a specialty population.

It includes both on-site and mail-order pharmacies.

As these specialty pharmacies provide medications for complex diseases, they need special storage, administration, and dispensing requirements.

If you’re thinking to start your specialty pharmacy then, you need to consider the following aspects of specialty pharmacies.

License Requirements for Specialty Pharmacy Owners

To become a Certified Specialty Pharmacist, you must meet the qualification criteria along with possessing the knowledge of specialty medicines, interventions, care plans, and patients.

The Qualification Criteria for Specialty Pharmacy Owners

  • You need to possess BSPharm or PharmD degree from an accredited university or college
  • You should not have any felony convictions
  • Your pharmacist license should be active and unencumbered
  • You should have 3,000 hours of experience in dealing with specialty medicines in 4 years
  • In the last 2 years, you should have 30 hours of continuing education in specialty pharmacy
  • You should have completed the Certified Specialty Pharmacist examination

Once you clear your Certified Specialty Pharmacist examination, you will require accreditation for your specialty pharmacy.

Your pharmacy will have to be fully licensed and operated in the US, be compliant with all the state business rules and regulations, and have a pharmacist in charge.

4 Major Accrediting Bodies for Specialty Pharmacy Owners

1. Accreditation Commission for Health Care (ACHC)
2. Utilization Review Accreditation Commission (URAC)
3. The Joint Commission
4. National Association of Boards of Pharmacy (NABP)

The eligibility requirements and the standards for each organization are different.

Depending on your choice of certification, the accreditation can take around 6 months to 3 years time period.

The Cost to Start a Specialty Pharmacy

As you start developing your specialty pharmacy plan, you should also include some basic working and pharmacy costs like,

  • Initial inventory stock
  • Operating expenses
  • Build-out costs

The special needs and requirements of the specialty pharmacy incur additional costs that may cut into profitability. These additional costs include:

  • Costs of purchasing specialty drugs
  • Certifications, accreditations, and training
  • Increased DIR fees for specialty drugs
  • Software solutions for pharmacy management and reporting
  • Handling, storage, and delivery

3 Ways You Can Start Your Specialty Pharmacy Business

1. Partnership

You can opt for partnering with an existing specialty pharmacy.

You will get instant access to the staff and resources.

The main advantage it offers is the shortest time to market.

2. Buying

You’ll have to invest more if you choose to purchase an existing specialty pharmacy.

You can enjoy all the advantages of established relationships and resources.

3. Building

Though starting a specialty pharmacy from the ground up requires the longest time to market, it is rewarding.

You may have to operate for a few years to become eligible for specialty accreditation.

Which Location Should You Choose for Your Specialty Pharmacy?

Most specialty pharmacies ship medicines directly to their patients.

Your plan of operation is vital when selecting the location of your specialty pharmacy.

1. Online or Mail-order Pharmacy
2. Brick and mortar Pharmacy

If you plan to build a brick-and-mortar pharmacy business, you need to consider 2 factors before finalizing your pharmacy location.

1. Proximity

Research the local competition and find higher traffic areas like main roads.

Large cities offer many competitors while the smaller towns may not be able to support multiple specialty pharmacies.

2. Accessibility

Search for areas with complementary businesses like doctor’s offices and other medical facilities.

You can easily take advantage of their plan and can even plan potential collaborations in the longer run.

IT Requirements of a Specialty Pharmacy

Specialty pharmacy requires different tech support than retail pharmacy due to their complex offerings and structure.

1. Pharmacy Management System

  • Should meet regulatory requirements
  • Should handle prescription records and lifestyle
  • Should manage medicine lifecycle and adherence

2. Patient Management Software

  • Should possess effective communication facilities like Interactive Voice Response or secure messaging

3. Billing and Claims Submission System

This software system will enable you to perform tasks such as,

  • Medical benefit verification
  • Medical billing
  • Claim submissions

4. Reporting Software System

With this system, you should be able to track

  • Patient interactions
  • Clinical documents
  • Patient medicine history

Consider an all-in-one Specialty Pharmacy Software

In today’s world, connectivity has helped pharmacies effectively serve patients.

An all-in-one solution can provide you with tools that can assist you in managing your specialty pharmacy.

At SyS Creations, we’re committed to transforming healthcare and the way you do business.

Our Specialty Pharmacy Solution is HIPAA compliant.

You can add your pharmacy distributors, suppliers, partners, and patients to this single software solution.

To learn more about how we can help you practice at the top of your license, get in touch with us today, or request your free software demo by filling out the form below.