Working With a Specialty Pharmacy

Approved by the Cancer.Net Editorial Board, 02/2015

Key Messages:

  • Although most people usually fill their prescriptions at their neighborhood retail pharmacy, some people with cancer may be referred to a specialty pharmacy to receive their medications.
  • Specialty pharmacies provide medications that may be difficult to deliver, require additional monitoring or support, or are expensive, such as medications for chronic diseases.
  • Specialty pharmacists may dispense cancer medications at a specialty pharmacy, cancer center, or some retail pharmacies.

A specialty pharmacy is a pharmacy that dispenses medications that treat cancer in addition to other diseases and chronic conditions, such as HIV/AIDS, hemophilia, and multiple sclerosis. Sometimes, these specialized drugs are not readily available at a retail pharmacy or are particularly expensive.

Drugs that are injected into a vein or infused into the bloodstream through a tube placed into a vein are sometimes given onsite at a specialty pharmacy. Even some pills or capsules that are swallowed are sometimes stored at a specialty pharmacy. These drugs usually require special care, such as refrigeration or other handling requirements. This is to ensure that the medication is taken properly and safely.

Where are specialty pharmacies located?

Some specialty pharmacies have physical locations in large cities. People with cancer 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 directly to people’s homes. These specialty pharmacies interact with their customers on the phone, usually on a monthly basis. During these calls, a member of the pharmacy staff can offer counseling and support services to help people understand their medications and medical conditions so they continue to take their medications exactly as instructed.

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

Look for a website for more information. Specialty pharmacies usually have websites that offer specific information and frequently asked questions. This is often a good place to start in terms of finding contact information or general cost questions. If a doctor’s referral is necessary, the forms may be on the website to download and fill out with your doctor’s office staff.

Talk to your insurance provider beforehand. Whether you are referred to a specialty pharmacy often depends on any arrangements your health insurance provider has with a specialty pharmacy. Be sure to ask your insurance provider if this is part of your individual coverage before filling your prescription. 

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 who will work with you, your insurance provider, and government programs, such as Medicare, to cover some of the costs of your medications.

Let the specialty pharmacy know of all other medications and supplements you are 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 dietary or nutritional supplements you are taking because these may also interfere with your cancer medications.

Tell the specialty pharmacy staff about any side effects. 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. For example, if you feel nauseated 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. If side effects do not go away or get worse, the counselor may work with the pharmacist and your doctor to switch you to another medication.

Order refills before you need them. It is important to have enough 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 you can promptly refrigerate the medications or perform any other special handling or storage 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.

More Information

Drug Information Resources

The Importance of Taking Your Medication Correctly

Safe Storage and Disposal of Cancer Medications