ASHP Survey Finds Growth, Opportunities for Health-System Specialty Pharmacy Services

Dear Colleagues,

One of ASHP’s fundamental responsibilities is to stay highly engaged with our members so that we can anticipate and meet their needs now and in the future. We do this in part through our large number of member advisory groups and by conducting a range of surveys about pharmacy practice trends and publishing the results so our members can use the data to set priorities and guide their practices.

I’m pleased to share findings from the 2022 ASHP Survey of Health-System Specialty Pharmacy Practice: Practice Models, Operations, and Workforce. This report was featured in the Dec. 15 print issue of AJHP.

Health-system specialty pharmacies (HSSPs) provide exceptional clinical care that consistently demonstrate practices surpassing the expectations of accrediting organizations. Our latest HSSP survey findings further highlight how HSSPs are raising the standards of quality in specialty pharmacy care.

HSSPs have direct access to their patient’s electronic medical records and the entire patient care team, which creates efficiencies in care and supports optimal medication use. And HSSPs that serve the specialty medication needs of all patients — including those who are required to get their medications from external pharmacies — demonstrate how integrated advanced practice models of care deliver the comprehensive services patients need.

Data from ASHP’s national surveys tell us that the proportion of hospitals that operate a specialty pharmacy tripled from 2015 (9%) to 2019 (27%). Our latest HSSP survey continues to see vibrant growth in this important practice area as HSSPs increasingly provide these critical services to patients and become a standard service line for hospitals and health systems.

As we look to the future, we know specialty medications will continue to get much attention with their high costs. ASHP’s latest report on prescription drug expenditures found that specialty medications accounted for 51% of total prescription drug costs in 2022. That’s an increase of nearly 12% from 2021 and a trend that ASHP has long been closely following as we work to address our country’s drug pricing challenges.

By operating their own specialty pharmacies, health systems can gain some control over their drug expenses — and their patients’ medication costs — while providing high-level, personalized, comprehensive medication management services that help patients achieve optimal outcomes. We shared an overview of these key aspects of HSSP practice in the 2022 ASHP Survey of Health-System Specialty Pharmacy Practice: Clinical Services, which appeared in the July 1, 2023, issue of AJHP.

The latest HSSP survey findings also confirmed that HSSPs rely on highly trained pharmacists. More than 60% of respondents said their pharmacists held specialty pharmacy certifications. Many others reported using pharmacists who are board certified in pharmacotherapy, ambulatory care, oncology, and other certifications. Survey respondents also reported that the majority of health-system specialty pharmacy technicians are certified.

The survey also found that specialty pharmacists have a high level of professional autonomy, with pharmacists being involved in treatment decisions and drug therapy selection.

HSSP survey respondents also provided information about the future of their operations.

The top challenge, cited by 75% of respondents, was access to payer networks. Two-thirds of respondents said network restrictions prevented them from filling more than half of the specialty prescriptions written within their health system. Forty-six percent of HSSPs reported that hiring and retaining qualified staff is a challenge, and 38% said shrinking reimbursement from payers is a major concern.

Solving these challenges is a key strategic priority for HSSPs — and for ASHP, as we advocate on behalf of our members.

The HSSP survey includes many other important findings that we encourage you to review. As the survey demonstrates, the HSSP landscape is evolving. Hospitals and health systems continue to establish specialty pharmacy services and engage pharmacists and technicians in ways that best serve the needs of patients who are being treated with specialty medications.

There is no doubt that the number of specialty medications will continue to grow in both number and complexity and that the need for leadership by pharmacy professionals in specialty pharmacy will be vital to optimal patient care. ASHP will be here to support those professionals and their organizations and will work to help create a future that best meets the needs of patients and communities.

Thank you for all you do for your patients and our profession.



Posted on January 26, 2024