Specialty Pharmacies

Last Reviewed: October 7, 2019

Question:

Dear OncoLink "Ask The Experts,"

My doctor tells me that I should get my cancer medicine from a specialty pharmacy. What is that and what are the pros and cons of using a specialty pharmacy instead of my usual pharmacy?

Answer:

Specialty pharmacies are pharmacies that manage the distribution of high cost or complicated medications. These pharmacies have staff trained in certain diseases, such as palliative care, HIV, transplant, and oncology. They offer education and support to hopefully improve the patient’s ability to take their medication correctly and safely. Most high-cost oral cancer medications are supplied by a specialty pharmacy. Many of these medications are only available through a few select specialty pharmacies.

The pharmacists at a specialty pharmacy will have the education and/or certification needed to be knowledgeable in the drug treatments, interactions, management of those interactions, toxicities, adverse reactions, etc., for that particular disease. This knowledge may help catch an error in dosing or an interaction with another medicine before it happens. These pharmacies may also compound (mix up) special forms of medications - like topical gels or suppositories.

Many of the newer oral cancer medications are filled only by specialty pharmacies. This means you cannot fill the prescription at a regular pharmacy. In addition, in many cases, only 1 specialty pharmacy carries a particular medication, so you can't just go to any specialty pharmacy. Typically your healthcare provider will initiate the order and the specialty pharmacy will send the medication to your home or provider's office. In some cases, the medication is being monitored because of a potentially serious side effect and the provider is required to teach you about this side effect and have you sign that you understand (called a REMS program). Medications covered under REMS programs include thalidomide, pomalidomide, lenalidomide, CAR-T therapies, and some pain medications.

You can learn more about specialty pharmacies on OncoLink.

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