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The Origin and Evolution of Specialty Pharmacy
Commencing in the early 1970s, specialty pharmacy was originally intended for patients requiring unique therapies for various conditions. Initially this included mainly infusions for hemophilia, cancer, or malnutrition[i]. Most of these offerings came with high costs (many of which can now be offset by copay assistance programs), and special storage and/or shipping requirements[ii].
Specialty pharmacy has since expanded rapidly, and Merck’s launch of indinavir (Crixivan®) in 1996 marked a significant milestone. As the third approved protease inhibitor for HIV treatment, the launch followed a record setting fast-track FDA approval. The decision to dispense Crixivan® exclusively through Stadtlanders specialty pharmacy[iii] set the tone for the limited distribution networks that we see today.
Between 1970 and 2000, most specialty medications were covered as a medical expense. However, a shift occurred in the early 2000s, with specialty transitioning to the pharmacy benefit. Today,
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