Contributed by Sheila Arquette, President & CEO, National Association of Specialty Pharmacy (NASP)
As the healthcare landscape evolves, specialty pharmacy remains at the forefront; dynamic, demanding, and often disruptive. The rapid pace of scientific discovery and medical innovation challenges providers across the care continuum to find smarter, more effective ways to support patients with complex conditions whilemanagingrisingcosts.In2025, the industry is experiencing unprecedented growth fueled by breakthrough therapies, digital transformation, and a steadfast commitment to patient-centered care. But with progress comes complexity. Stakeholders must now navigate escalating costs, increased regulatory oversight, and shifting expectations from payers, all while maintaining quality, access, and outcomes.
The Pulse of Progress
Key Trends in 2025
1. Market Momentum
Specialty pharmaceuticals now account for more than half of total drug spending in the U.S., with global market projections nearing $965 billion by 2030. This exponential growth is fueled by the rise of biologics, targeted therapies, and treatments for chronic and rare diseases.
2. Cost Control Takes Center Stage
Payers are reevaluating traditional pricing strategies, with growing interest in cost-plus models and rebate-free alternatives, part of a broader movement toward transparency and value-based care. At the same time, biosimilars are gaining momentum
as cost-effective substitutes for higher-priced biologics. Yet amid these shifts, it’s critical not to lose sight of what defines specialty pharmacy: a high-touch, patient-centric model rooted in clinical excellence and care coordination. Reducing the conversation to drug price alone risks diminishing this comprehensive approach to a transactional one.
3. Digital Transformation
Artificial intelligence and advanced analytics are revolutionizing specialty pharmacy operations. From predictive adherence tools to personalized patient engagement platforms, technology enhances outcomes while streamlining care delivery.
4. Health System Integration
Health systems are increasingly bringing specialty pharmacy services in-house. By 2028, they are expected to control 25% of the specialty pharmacy market, with nearly all large systems operating their own specialty pharmacies.
The Roadblocks
Challenges Ahead
1. The High Cost of Innovation
While cell and gene therapies (CGTs) offer life-changing potential, their development and delivery come at a steep price. These therapies challenge traditional reimbursement models and strain payer budgets.
2. Regulatory Uncertainty
The 340B Drug Pricing Program is under intense scrutiny, with new state laws and legal battles reshaping its future. At the same time, pharmacy benefit managers (PBMs) face mounting pressure to increase transparency and reduce anti-competitive practices.
3. Patient Engagement Gaps
Despite technological advances, patient adherence remains a continued focus. Therapy discontinuation underscores the need for more robust support systems and behavioral interventions.
The Upside
Opportunities for Growth
1. Embracing Value-Based Care
Uniquely positioned, specialty pharmacies support value-based care models, aligning reimbursement with outcomes and improving clinical and financial performance.
2. Expanding Clinical Services
Offering services such as medication therapy management, genetic counseling, and remote monitoring can differentiate specialty pharmacies and expand their scope in the carecontinuum.
3. Strategic Collaborations
Partnerships between specialty pharmacies, manufacturers, payers, and providers are unlocking new innovation, access, and affordability pathways. These alliances are critical to navigating the complexities of specialty drug delivery
and patient and disease management.
4. Biosimilar Innovation
As more biosimilars enter the market, specialty pharmacies have an opportunity to lead in education, adoption, and cost savings, helping to reshape the economics of specialty care.
Looking Ahead
Specialty pharmacy in 2025 is an industry in motion —complex, fast-growing, and full of promise.
By embracing innovation, addressing systemic challenges, and keeping patients at the center, we can shape a future where specialty therapies are not only advanced but also accessible and affordable.
ABOUT NASP
The National Association of Specialty Pharmacy (NASP) is a 501(c)(6) non-profit trade organization and is the only national association representing all stakeholders in the specialty pharmacy industry. The mission of the National Association of Specialty Pharmacy (NASP) is to empower specialty pharmacy stakeholders to advance the standard of patient care. NASP provides an online education center offering accredited continuing pharmacy education programs, hosts an annual meeting and expo that offers educational sessions and continuing education credits, and is the only organization that provides a certified specialty pharmacist credential through the Specialty Pharmacy Certification Board (SPCB). NASP members include the nation’s leading specialty pharmacies, pharmaceutical and biotechnology manufacturers, group purchasing organizations, patient advocacy groups, integrated delivery systems, law firms, health plans and PBMs, technology and data management vendors, wholesalers/distributors, logistics providers, practicing pharmacists, pharmacy technicians, nurses, and healthcare professionals.
