U.S. Healthcare Services: A summary of our teach in on specialty pharmacy

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U.S. Healthcare Services: A summary of our teach in on specialty pharmacy

21 July 2026

U.S. Healthcare Services

U.S. Healthcare Services: A summary of our teach in on specialty

pharmacy

We held a teach-in on Specialty Pharmacy last Wednesday to provide a detailed Lance Wilkes

+1 917 344 8501 overview of the specialty pharmacy industry, including its history, economics, and

lance.wilkes@bernsteinsg.com competitive dynamics. This note summarizes key takeaways from the webinar (see replay

here and slides here).

Adam Chow

+1 212 845 7820 What is specialty pharmacy -Specialty pharmacy differs from traditional retail pharmacy adam.chow@bernsteinsg.com

because it focuses on high-cost, complex therapies, many of which are biologics.

Kevin Peterson Although specialty medications account for only 3-4% of prescription volume, they

+1 917 344 8358 represent more than half of total drug spending and have been one of the fastest growing

kevin.peterson@bernsteinsg.com areas of the pharmaceutical market. Specialty drugs may be covered under either the

pharmacy or medical benefit, with approximately 2/3 of spending occurring through the

pharmacy benefit and 1/3 through the medical benefit, depending on how the therapy is

administered.

Business models - Unlike PBMs, which manage drug benefits and negotiate rebates,

specialty pharmacies generate revenue by dispensing medications and providing clinical

support, making them less exposed to regulatory and policy risk. Compared with retail

pharmacies, specialty pharmacies are typically centralized distribution operations that

emphasize patient support services and are heavily involved with home delivery.

Specialty pharmacy economics - Despite dispensing relatively few prescriptions,