As the healthcare landscape evolves, specialty pharmacy
remains at the forefront; dynamic, demanding, and often
disruptive. The rapid pace of scientific discovery and medical
innovation challenges providers across the care continuum
to find smarter, more effective ways to support patients with
complex conditions while managing rising costs. In 2025,
the industry is experiencing unprecedented growth fueled by
breakthrough therapies, digital transformation, and a steadfast
commitment to patient-centered care. But with progress comes
complexity. Stakeholders must now navigate escalating costs,
increased regulatory oversight, and shifting expectations from
payers, all while maintaining quality, access, and outcomes.
The Pulse of Progress
Key Trends in 2025
Market Momentum
Specialty pharmaceuticals now account for more
than half of total drug spending in the U.S., with
global market projections nearing $965 billion
by 2030. This exponential growth is fueled by
the rise of biologics, targeted therapies, and
treatments for chronic and rare diseases.
Cost Control Takes Center Stage
Payers are reevaluating traditional pricing strategies,
with growing interest in cost-plus models and rebate-
free alternatives, part of a broader movement
toward transparency and value-based care. At the
same time, biosimilars are gaining momentum
as cost-effective substitutes for higher-priced
biologics. Yet amid these shifts, it’s critical not to
lose sight of what defines specialty pharmacy: a
high-touch, patient-centric model rooted in clinical
excellence and care coordination. Reducing the
conversation to drug price alone risks diminishing
this comprehensive approach to a transactional one.
Digital Transformation
Artificial intelligence and advanced analytics are
revolutionizing specialty pharmacy operations.
From predictive adherence tools to personalized
patient engagement platforms, technology enhances
outcomes while streamlining care delivery.
Health System Integration
Health systems are increasingly bringing specialty
pharmacy services in-house. By 2028, they
are expected to control 25% of the specialty
pharmacy market, with nearly all large systems
operating their own specialty pharmacies.
The Roadblocks
Challenges Ahead
The High Cost of Innovation
While cell and gene therapies (CGTs) offer
life-changing potential, their development
and delivery come at a steep price. These
therapies challenge traditional reimbursement
models and strain payer budgets.
Regulatory Uncertainty
The 340B Drug Pricing Program is under intense
scrutiny, with new state laws and legal battles reshaping
its future. At the same time, pharmacy benefit
managers (PBMs) face mounting pressure to increase
transparency and reduce anti-competitive practices.
Patient Engagement Gaps
Despite technological advances, patient adherence
remains a continued focus. Therapy discontinuation
underscores the need for more robust support
systems and behavioral interventions.
Navigating the
Innovation
FALL 2025 I RETAIL/COMMUNITY • SPECIALTY • LTC
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SPECIALTY PHARMACY 2025