The Role of Consulting in Specialty Pharmacy

Expert companies are a worthwhile portion of the specialty pharmacy room. To convey a new drug to market, purchasers are confronted by various substantial obstacles, these types of as contracting with payers, planning pricing and reimbursement products, assortment of specialty pharmacy/hubs, and planning the client journey. Each phase can pose precise challenges to a customer, and know-how gaps may well exist at any phase that could negatively influence a drug start.

Consultants fill in understanding gaps and can establish and put into practice effective strategies that strengthen a drug’s prospects of accomplishment. A good romantic relationship amongst the proper consulting agency and the right shopper can sleek the system of bringing a remedy to marketplace and support consumers in getting their solutions into the arms of people in need of therapy speedily and efficiently.

Guide providers are various with particular companies specializing in a variety of segments of the current market comprehensive beneath.

Payer/market place contracting

At the coronary heart of a client’s problems is the query of how they are going to get insurance coverage designs to protect their new therapy. Payers have the greatest impact on the money success of any new drug launch.

Knowing the challenging world-wide-web of insurers, bargains from federal government and professional options, and payer obtain is exceptionally difficult. Specialist companies possess awareness and relationships in just the 3rd-occasion payer landscape that support ease consumer issues and make certain correct contracts are secured with health insurance coverage providers that favorably position therapies on drug formularies and limit the sum of red tape needed to obtain strategy acceptance.

In addition, as well being insurance coverage premiums increase and wellbeing care fees rise, consultants can work with businesses intently to carry out new billing styles, these as virtual health and fitness products and services and HMOs, that help save dollars for insurers and individuals.

Policy, pricing, and reimbursement

Plan and pricing are an at any time-shifting landscape. There have been numerous drug pricing policy reforms enacted previously and even further reforms are predicted to release this 10 years.

Suppliers have to keep up to date information to recognize what has took place and what is on the horizon that may possibly affect pricing. Consultants with awareness across regulatory bodies can aid makers in understanding the current regulatory framework that impacts pricing so that they can enhance selections in this arena.

Market and aggressive intelligence

Consultants can provide aggressive positive aspects to purchasers by leveraging their encounter inside of the field to give in depth insights into the marketplace. Companies have several years of practical experience behind them in just the market place that they use to increase customer outcomes nevertheless expert services, these types of as giving marketplace trends and forecasts.

Channel system

When a new drug is coming to sector, decisions have to be created on which type of a specialty pharmacy community will be used and which specialty pharmacies will participate in that network. Hubs and third-social gathering logistics sellers can also be component of that discussion, as very well as the earlier reviewed insurance payers.

Each entity operates uniquely and sometimes can conflict with how other entities work. Consultants can support clientele in producing channel conclusions that can ensure the client’s individualized prepare will be implemented, optimizing the client journey.

Individual services, accessibility, and affordability

Consultants can support improve a client’s model practical experience by helping in the improvement of individual expert services. There is a huge require for such services, as prescription abandonment and adherence degrees are concerningly high even for specialty drug populations.

A consultant can also guide in the advancement of individual guidance courses that get medicines in the hands of people most in want of therapy. The medically underserved, underinsured, or those people ready on clearance of in some cases prolonged prior authorization protocols can acquire complete obtain to free of charge medicine, full with a suite of client products and services by these applications.

Marketing and advertising

Client promoting teams should recognize how all the parts of the specialty pharmacy landscape—from vendors to payers, people, and pharmacies—interact to make certain a product or service launch is prosperous. Consumers can function cross-functionally to deliver a drug from a idea to a launch productively.

They can support with products strategy and start, leveraging understanding of drug therapeutic options, patient bases, pricing, and reimbursement scenarios, to give the client’s advertising and marketing a detailed graphic of the market place. By being familiar with the affect of just about every stakeholder, a client can far better style and design their advertising approaches.

Spouse performance evaluation

Info are incredibly beneficial in today’s specialty pharmacy business. Details can be used to boost every single one component of a client’s approach, such as advertising, pricing, affected individual services, and logistics.

Information can also be extremely complex to get, mixture, and have an understanding of. Consultants can carry relationships and understanding of third-get together knowledge providers and aggregators to clientele and clearly show them how data could be utilized to make improvements to the affected person journey. Consultants can also help customers leverage knowledge to better management the physical and economic transactions that help the affected person.

Consultant companies deliver revenue by charging hourly service fees, related to how an impartial contractor or a lawyer may bill for their expert services. Based on the stage of service essential for a specified task, consultants can be brought “in house” to have a full-time, in-man or woman place of work presence, or they can provide expert services from a distance as a result of their own offices. In addition to hourly service fees, consultants can obtain revenue by gathering finder’s charges when connecting shoppers with other services vendors/personnel that greatly enhance their results.

At this time there are several consulting companies of differing measurements inside the market place. To spotlight a couple, TwoLabs Pharma Services is a single of the major at more than 120 employees.

They expanded substantially in 2018 when they obtained MKO World wide Partners and in 2020 when they included CEEK Enterprises.1 Archbow is a medium-sized (<25 employees) consulting firm that was recently acquired by the Omnicom Health Group in April 2021.2

Protean is a smaller consulting firm that specialized in market access, patient services, and payer contracting that was recently acquired by Eversana in October 2021.3 A few consulting firms that are of smaller size include Route3, Perspective3, Katz, and many others.

There are plenty of other players within this market, consisting of various sizes and offering a variety of expertise. Vynamic is a multinational firm that has specialized knowledge in health plants, health care technology, providers, public health regulation, and life sciences.

CSI Group is a firm that exclusively operates as a B2B marketing and creative agency that develops initiatives to improve brand and product recognition. The Dedham Group is a market access firm focused on oncology and specialty therapeutics.

Zensights specializes in vendor/supplier engagement issues. There are many other specialized firms that provide focused expertise in any area of concern a manufacturing client may seek assistance in.

As demonstrated above, the specialty pharmacy consulting space is constantly evolving. New players are being added through startups and others are being acquired or merging.

These activities can have an implication on the overall marketplace. One of the implications is that mergers and acquisitions of firms can lead to an overall reduction in the impartiality of consultant groups in directing business toward certain channels or entities.

The recent acquisition of Protean by Eversana—a leading provider of global consulting services to the life sciences industry—will improve Eversana’s reach and presence, no doubt. It also can potentially impact impartiality and independence of consulting services through conflicts of interest.

Although it is true conflicts of interest are often a part of business, with mergers and acquisitions becoming a regular part of this marketplace, a commonly used and trusted consultant can be acquired by a firm that may pose a conflict of interest. Perhaps the purchaser consults for your primary competitor. Such scenarios can complicate relationships between consulting firms and manufacturers.

Impartiality is a concern within the overall market. Clients not only have to navigate the uncertain waters for which they are hiring consultants, but they also must navigate consultant recommendations in channel decisions knowing that the space has a reputation for partiality.

Often, firms will collect finder’s fees from various channel entities for directing business toward them. This reputation of partiality is acknowledged by the consulting firms themselves.

For example, Blue Fin Group states on their website, “we are very proud to be the only neutral consulting organization in the industry meaning that we do not take any incentives from channels to direct business toward them – which is a common practice in this industry.”4

This quote is telling in that it alleges finder’s fees for channel decisions are widely practiced within the industry to such an extent that a firm believes it can market itself as impartial to gain an advantage over its competition. As the specialty pharmacy market continues to expand over the next several decades, so too will the accompanying consultant services landscape expand.

Consultants can offer valued knowledge and expertise to specialty drug manufacturing clients and help ensure a smooth process when taking a new therapy to market. They often can be THE reason for a specialty drug gaining first mover advantage or achieving dominant market share over competitors.

However, the overall specialty consulting market has a reputation for partiality when directing business toward channels that provide kickbacks to the consulting firms. As the consulting market continues to develop, it will be interesting to witness if this reputation persists.

About the Author

Daniel Paul earned his Bachelor of Science in Biology from Allegheny College and his Doctor of Pharmacy degree from Duquesne University in Pittsburgh. He is currently earning a Master of Pharmacy Business Administration (MPBA) at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines. Dan has spent the last 2.5 years working in Specialty Pharmacy, initially as a clinical pharmacist and most recently as the Manager of Pharmacy Operations.


  1. Two Labs Acquires MKO Global Partners. Accessed January 23, 2022.
  2. Omnicom Health Group Acquires Archbow Consulting. Published April 14, 2021. Accessed January 24, 2022.
  3. Eversana Acquires Protean Strengthens Operational Strategy and Excellence in Market Access, Channel and Patient Services. Published October 15, 2021. Accessed January 24, 2022.
  4. Blue Fin Group, An IntegriChain Company website. Accessed January 24, 2022.

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