Learn more about the duties, practice settings, typical workdays, and educational opportunities, as well as personal advice from pharmacists in this practice area.
What is health-system specialty pharmacy?
Specialty pharmacy does not have a standard definition across all practice areas. Generally, specialty pharmacy medications are complex therapies that require significant pharmacist involvement to help promote adherence, minimize side effects, and mitigate the potential for significant financial burden on patients. Specialty pharmacy is a unique blend of clinical and operational aspects that requires high patient touch and unique skill sets. Typical specialty pharmacy populations include rheumatology, inflammatory diseases, oncology, infectious diseases, multiple sclerosis, transplant, and orphan diseases.
Specialty pharmacy practice can also involve comprehensive outpatient pharmacy care, catering to specific patient populations. The unique ability to access the health-system electronic medical record (EMR) allows for specialty pharmacy pharmacists to fully understand the patient journey and effectively contribute to successful patient outcomes through education, proactive outreach, dispensation of both product and supportive materials, and 24/7 access.
Where does a specialty pharmacist work?
Traditionally, specialty pharmacists have worked centrally and are involved in the dispensing of the specialty pharmacy medications. However, there is a significant amount of additional responsibilities including adherence assessments, clinical education, side effect monitoring, medication assistance, etc. that sets specialty apart from traditional retail pharmacy. Health-systems have moved to a more decentralized model where specialty trained pharmacists are embedded in the specialty clinic and are involved in treatment decisions and collaborative practice agreements with physicians.
For example, pharmacists can be cross-trained to work in both production and clinical outreach. Areas in which pharmacists may work include outpatient specialty pharmacies, a call center, and WFBH specialty clinics. Pharmacists in a distribution area may participate in the clinical review of specialty prescriptions along with final product checking, final financial reviewing, and ensuring a proper delivery method. The call center staffs cross-trained pharmacists who triage incoming phone calls and patient interventions while others make outbound calls to patients, assessing their therapy and progression towards therapeutic goals. Clinic-embedded pharmacists interact with patients to provide education on various specialty medications available per indication, in addition to financial access to specialty medications, and assistance to providers with creating appeals to therapies denied by insurance.
What does a typical workday look like?
For a specialty pharmacist, a typical day depends on the practice setting. Many specialty pharmacies are held to rigorous accreditation standards that require many program aspects including a call center, quality committee, clinical management program, etc. Depending on the program set up, pharmacists may be involved in dispensing, clinical education of patients, medication assistance, and much more. Many specialty pharmacies also provide value added services such as mail order, after-hours clinical support, etc. Many specialty pharmacists also work directly in the clinics and are involved with responsibilities such as prescribing and monitoring.
What educational opportunities are available for pharmacists in this area?
- There is a board certification that was developed in collaboration with the National Association of Specialty Pharmacy (NASP) called a Certified Specialty Pharmacist (CSP). This certification requires continuing education, on-the-job experience, and a national examination, and tests the candidate in broad areas of specialty pharmacy including clinical and operational aspects.
- Many successful specialty pharmacists also complete a BPS certification in their specialty (BCPS, BCIDP, BCOP, BCACP, etc.).
How can I learn more about this career path?
- There are many resources provided by ASHP on specialty pharmacy as a career, including many CE presentations on the clinical and operational aspects of specialty pharmacy.
- ASHP has a dedicated Specialty Pharmacy Resource Center for more information about specialty pharmacy and tools to help you understand the practice.
- ASHP has SSPP Member Spotlights to highlight the work of some specialty pharmacists.
Member Career Profiles
Nick Gazda, PharmD, MS, BCPS
Assistant Director of Specialty Pharmacy Services
Cone Health
What interested you in pharmacy and this career path?
“Specialty pharmacy is a unique area of pharmacy that gives pharmacists an opportunity to be involved in many aspects of care for patients. Specialty pharmacy patients are also very complex and are typically dealing with complex and chronic diseases. It is very rewarding to be able to help patients navigate through difficult side effects, provide clinical education, and help patients afford expensive medications through copay assistance and grant programs.”
What advice do you have for someone interested in this career field?
“Postgraduate education in the form of a residency is the best way to prepare for a career in specialty pharmacy. A PGY1 community residency is excellent for more broad experience, or a PGY2 specialty if you are interested in working in the clinic setting. Internships are also great and can help give students experience in the specialty pharmacy setting.”
Jennifer Young, PharmD, BCPS, CSP
Program Director II, Specialty Pharmacy Services
Wake Forest Baptist Health
What interested you in pharmacy and this career path?
“The unique ability to combine a clinical skillset in an outpatient setting with the entire medication dispensing process. Pharmacists are integral in therapy decisions, product fulfillment, education, administration, and both short-term and long-term patient outcomes. There are multiple opportunities to become involved with research, teach both pharmacy student and resident learners, work towards a unique CSP certification, and constantly learn through newly approved, novel medications continuously coming to market. In addition, the ability and expectation to provide comprehensive education to patients receiving a specialty medication allows for the development of trusting patient relationships.”
What advice do you have for someone interested in this career field?
“If given the chance during clinical experiences in school, choose a rotation with a specialty component. If such a rotation is not assigned or available, I would suggest shadowing a specialty pharmacist to better understand the many processes that come together to care for the whole patient. Each member of the specialty team must work together in order for a patient to receive the best care; understanding the workflow process from intake to dispensing and continued follow-up will allow for understanding of both the medication and patient journey, in addition to the multiple roles a pharmacist plays in the process. If a student works at a retail pharmacy, ask their manager if there is a specialty location within the state and if they can visit or spend the day with the specialty team. Seeking out additional educational and/or certification opportunities post-graduation may also attest to the motivation one has to continuously learn.”