Most people visit their neighborhood retail pharmacy to fill prescriptions for medications. However, some people with cancer may be referred to what are known as specialty pharmacies to receive medications.

What is a specialty pharmacy?

Specialty pharmacy is an evolving industry. A specialty pharmacy:

• Dispenses medications that treat cancer in addition to other diseases and chronic conditions, such as human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), hemophilia, and multiple sclerosis. Sometimes, these specialized drugs are not readily available at a retail pharmacy.
  
  
• Supplies and delivers medications that require special care, such as refrigeration or other handling requirements.
  
  
• Stocks oral drugs (taken by mouth) that treat cancer in addition to medications that are injected or infused. These drugs may either be taken at home or are sometimes given onsite at a specialty pharmacy.
  
  
• Offers counseling and support services to help patients understand their medications and medical conditions so that they continue to take the prescribed medications.

In general, specialty pharmacies focus on delivering medications to people that may need additional monitoring and support services than what is typically performed by a retail pharmacy.

Interacting with a specialty pharmacy

Whether you are referred to a specialty pharmacy often depends on any arrangements that your health insurer has with a specialty pharmacy, if insurance is covering the cost. Be sure to ask your insurance provider if this is part of your individual coverage beforehand.

Some specialty pharmacies have physical locations in large cities in the United States. Patients may visit these sites to pick up their medications or have them administered there. They may also talk with a pharmacist and other members of the specialty pharmacy team about their medications.

Other specialty pharmacies do not have physical store locations but ship medications to patients directly to their homes. These specialty pharmacies interact with their customers on the telephone, usually on a monthly basis, to check in and monitor their conditions.

The specialty pharmacy care team

In addition to pharmacists, specialty pharmacies generally employ certified pharmacy technicians, registered nurses, case managers, and counselors. These professionals perform several important tasks, such as reviewing medication and dosing schedules, discussing injection and infusion techniques, and teaching patients how to dispose of waste properly.

Tips for working with a specialty pharmacy

Ask about the counseling and support services offered. Many specialty pharmacies offer around-the-clock telephone support lines where you can speak with members of the specialty pharmacy care team. Ask any questions you have about your condition or medications. Many specialty pharmacies also have reimbursement specialists that will work with you, your insurance provider, and government programs, such as Medicare, to cover some of the costs of your medications. If you are having difficulty coping with your cancer, some specialty pharmacies may refer you to other counseling and support services.

Let the specialty pharmacy know of all other medications and supplements you're taking. It may be a good idea to have all of your medications, including ones for other conditions, filled at the same pharmacy. Also, notify the pharmacy of any allergies you have to medications, and tell them what foods, beverages, and dietary or nutritional supplements you are taking, because these may also interfere with your cancer medications.

Tell the specialty pharmacy staff how you are feeling physically. For example, if you are having an upset stomach after taking your medication, the nurse or counselor may suggest that you take the medication at a different time of day, or take the pills with food. The counselor's role is to encourage you to take the recommended dose and follow the schedule as pre-scribed by your doctor, including the right amount of medications at the right time for the pre-scribed length of treatment. If the side effects do not go away or worsen, the counselor may consult with a pharmacist and your doctor to switch you to another medication. By accurately describing how you are feeling, the counselor can assist you with managing side effects and can help you develop the best plan to take your medications.

Order refills before needed. It is important that you have an adequate amount of your medication at home so that you can take your medication on schedule without running out before your next shipment. If you plan to be away from home, the specialty pharmacy often can ship your medications to your temporary location. Ask the specialty pharmacy if there is a location at your destination. For medications that require special care, such as refrigeration, it is important that you are there to receive the shipments so that you can promptly refrigerate the medications or perform any other special handling requirements.

If you are injecting or infusing your medications at home, ask for a training visit. A nurse or counselor can demonstrate the proper way for you to administer your medicine, including how to handle supplies such as needles, syringes, adhesive bandages, and alcohol swabs.

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