Pharmaceutical Commerce - March/April 2018 - 9
OV E RV I E W
this service was for
educating physicians and their
office managers on specialty
pharmaceutical requirements; now,
our work is dominated by providing
assistance to patients themselves.
Ashfield Patient Services
having founded RxCrossroads in 2000, sold it to Omnicare
where he eventually became president, and then left that
company after it was acquired by CVS Health. He's now
reassembled some of the original RxCrossroads team.
All these firms-and others-compete in a space
dominated by the specialty services operations of the big
PBMs-Express Scripts' Accredo Pharmacy and Curascript
distribution services; Coram, CVS Health's specialty
infusion business; BriovaRx, now owned by OptumRx; and
Walgreens Specialty Pharmacy. Lash Group, a business unit
of AmerisourceBergen, is a leading hub services provider
(see story, p. 20), while Cardinal Health's Specialty Solutions
unit has expanded into hub services (see p. 16). Something
of an outlier is Covance, a contract research organization
(CRO) but one that has a Market Access business unit for
comprehensive hub services.
Accredo, Coram and other PBM-associated specialty
pharmacies are big enough to justify their own inclusion in
the limited-distribution networks set up by some pharma
companies to dispense their products; these limited
networks enable pharma companies to exert some control
over how their drugs are dispensed and followed up with
services. Independent specialty pharmacies represent
another option. A recognized leader in this channel is
Diplomat Pharmacy, which went through the exercise of
setting up a hub service, Envoy Health, that is "firewalled"
(Diplomat's term) from the rest of the company. The firewall
enables Diplomat to present an option to manufacturers
that want to keep hub services separate from pharmacybased services. And, in an action that certainly makes sense
from the Diplomat perspective of providing comprehensive
services, but which blurs the distinctions between trade
channels, the company acquired two small PBMs last year,
and so can be involved in price negotiations with pharma
companies even while fulfilling prescriptions.
Other specialty pharmacies are big enough to offer an
alternative distribution channel to manufacturers; Avella
Pharmacy is often mentioned in this context. ExceleraRx
is a network of academic medical centers (primarily) that
enables manufacturers to tap into that hospital segment.
Another network is Kloudscript, which says it has brought
together the independent pharmacies of 500 communities
across much of the continental US to provide specialty
care, including hub services.
Choose your flavor
The hub provider business-and the nature of patient
support and its relevance to various disease states-is such that
manufacturers can choose what area of expertise or skill the
service provider offers.
Ashfield Patient Services is an example of this.
Alongside a substantial (and international) contract sales
organization, Ashfield offers trained clinical educators
in a variety of disease states. "Originally, this service was
03. 2018 / Visit our website at www.PharmaceuticalCommerce.com / 9