NASP tries to get in front of specialty-pharmacy criticism


Valeant-Philidor dispute causes a 'mischaracterization' of specialty pharmacy

The clash between Valeant, investors and regulators over the company’s less-than-clear relationship with a specialty pharmacy, Philidor, has generated a response from the National Assn. of Specialty Pharmacy (NASP; Alexandria, VA). The fairly new organization (it came into being in 2012) represents specialty pharmacies (SPs) themselves and distributors as well as manufacturers.

“The fact that a company calls itself a specialty pharmacy does not make it so. Simply stated, charging high prices for medications does not define a specialty pharmacy,” says a statement released by the organization on Oct. 27. “Specialty pharmacies provide medications and related high touch health care services to seriously ill people who need complex medications, assistance in using these medications properly and not infrequently, assistance with reimbursement.”

The “mischaracterization,” says Robert Fulcher, COO of the organization, is that the media coverage of the Valeant-Philidor situation has implied that SPs exist only to sell high-priced medications. Fulcher notes that many of the leading SPs have gone through the expense and difficulty of obtaining national certification, which exists primarily through either the URAC organization or the Accreditation Commission for Health Care (ACHC). (A third source, itself just getting into the specialty arena, is the Center for Pharmacy Practice Accreditation, sponsored by the American Pharmacists Assn. and others.)

The problem, for NASP and others, is that SP is a self-identified category: you are one if you say you are. The accreditation processes mostly function to verify to health systems and others that a particular pharmacy is equipped to handle complex disease therapies. And it’s worth noting that Philidor, the pharmacy mostly handling Valeant products, is not accredited by URAC or ACHC, at least based on a check with the online resources those organizations maintain. NASP’s membership is not restricted to accredited SPs; in fact, just about any interested business can join.

Pharmacy as a registered business activity exists mostly on the state level and at least so far, few if any states have made any movement to create a separate regulatory category for SPs. Manufacturers’ stake in the matter arises when the complexity of obtaining and administering a drug interferes with patient access to that drug; manufacturers pay fees to SPs to manage certain ancillary services for that access. It remains to be seen whether the Valeant-Philidor situation (now a subject of an internal review by Valeant’s board, along with other governmental probes into Valeant pricing practices) will change the course of SP evolution.

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