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How Specialty Pharmacies Provide an Extra Level of Care to Help Manage Your Condition

By Molly Borchardt | February 18, 2021 | 5 min read | Insurance Education, Terminology, Tools and Services

Black male pharmacist in white coat reaches for a medication on top shelf at pharmacy

When you or a loved one lives with a chronic condition, managing medications can be overwhelming.

One of the biggest challenges of managing chronic illness is accessing affordable, quality care and medicines. Chronic diseases often require specialty drugs. These are high-cost and complex medications. They require more oversight and management than other prescriptions.

Unfortunately, most medications like these can’t be purchased or filled at every pharmacy. They’re sold at specialty pharmacies instead. Many of these drugs are injectable or have unique handling and administration requirements. So specialty pharmacies help meet the requirements of these medications and the patients that need them.

The cost of specialty drugs has skyrocketed in recent years. In fact, it increased an average of 23% in 2020.

To combat the rising costs while keeping standards of care high, Blue Cross and Blue Shield of North Carolina maintains a specialty pharmacy network.

The network includes local and national pharmacies that meet rigorous quality criteria. All of these pharmacies are accredited through URAC, a national and independent organization that promotes health care quality and efficiency. This network is critical in making these medications more affordable to our members. It also ensures these drugs are handled, stored and distributed appropriately.

Terms to know

chronic condition or disease is a persistent or long-lasting illness. Common chronic diseases include arthritisasthmacancer and Lyme disease. Some viral diseases, such as hepatitis C, are considered chronic conditions.

Specialty drugs are costly drugs that may be injectables and require special handling and administration. View our specialty drugs list.

Specialty pharmacy focuses on high cost, high touch medication therapy for patients with complex diseases. In this setting, pharmacists may work in a variety of areas. These areas include dispensing, medication therapy management, patient advocacy and therapy compliance.

These pharmacies, along with their qualified pharmacists, are important to our members. They give patients the highest quality medication, monitoring, consultation and care.

Any pharmacy in North Carolina can apply to and join our specialty pharmacy network if it can meet requirements. It must be able to serve members with complex chronic conditions. Specialty pharmacies that are part of the network must provide services, including:

  • Nursing or pharmacist services 24 hours a day, 7 days a week, 365 days a year. A Care Team led by highly trained pharmacists and nurses is ready to assist you. They can talk to you about your condition and are specially trained to help.
  • Individualized care. Disease-specific initial and ongoing evaluations, monitoring of medication adherence and counseling. If you have side effects, your Care Team will work with you to manage them. Nurses are available to assist with infusions in your home. They can also instruct you on how to inject medications.
  • Convenient and free mail order service. Medications are delivered to a customer’s location of choice.

For more information on our specialty pharmacy network, click here.

Important resources