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Association between integrated specialty pharmacy care model and pharmaceutical access and costs
Alexandra G Hames1, Geronimo Bejarano1,2, Insiya B Poonawalla1
1Humana Healthcare Research, Inc, Louisville, KY 40202, United States.
Health Affairs Scholar
|August 11, 2026
Summary
Integrated specialty pharmacy care models improve medication access and reduce costs for patients with complex conditions. This model offers faster prescription fills and lower out-of-pocket expenses for beneficiaries.
Area of Science:
- Health Services Research
- Pharmaceutical Economics
- Healthcare Management
Background:
- Health care consolidation presents mixed patient outcomes.
- The impact of insurer-specialty pharmacy integration on patient care is understudied.
- Vertical integration may increase market power, potentially raising costs.
Purpose of the Study:
- To evaluate the association between integrated specialty pharmacy care models and pharmaceutical access and costs.
- To assess the impact on beneficiaries managing complex specialty conditions in 2024.
Main Methods:
- Cross-sectional study using Humana prescription claims data.
- Adjusted regression analyses were employed.
- Evaluation focused on the integrated specialty pharmacy care model versus nonintegrated models.
Main Results:
- Integrated models reduced time from prescription to fill by -5.7 days.
- Beneficiary pharmacy costs decreased by $106 annually.
- Beneficiary specialty drug costs reduced by $77 annually.
- Additional benefits observed for patients using integrated primary care services.
Conclusions:
- Integrated specialty pharmacy care models can enhance pharmaceutical access.
- These models demonstrate potential for reducing healthcare costs for beneficiaries.
- Further research into integrated care models is warranted.
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