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?
Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:
A specialty pharmacy has clinicians trained in certain disease states, such as palliative care, HIV, transplant, oncology and some are beginning to work with health conditions like diabetes. They typically work with a high cost or high complexity disease state in the hopes of improving are for those patients. Most high cost oral cancer medications are supplied by a specialty pharmacy.
The pharmacists at the specialty pharmacies will have the applicable education and/or certification for disease state management and will have greater knowledge of drug treatments, interactions, management of those interactions, toxicities, adverse reactions, etc., for that particular disease state. While hopefully any medication error will be spotted at any pharmacy, the odds are increased if the pharmacist is intimately familiar with that particular disease state, dispenses many prescriptions for those medications, and knows the prescribing habits of local physicians. They also may or may not compound (mix up) special dosage forms of medications like topical gels or suppositories for medications not commercially available in those dosage forms. In addition, specialty pharmacies will stock all drug therapies for that disease state, rather than the local pharmacy having to special order them.
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 potential serious side effect and the provider is required to teach you about this side effect and have you sign that you understand. Medications covered under such programs include thalidomide, pomalidomide, lenalidomide.
You can learn more about specialty pharmacies on OncoLink.