Disease Burden Is Rising. Is Your Health System Ready?
The data is hard to ignore. Rates of chronic disease, cancer, and complex conditions are climbing. With them, the demand for specialty medications is accelerating at a pace that demands health systems to proactively align resources to serve their populations’ medication management needs. As a healthcare leader, the time to position your organization is now.
As Dave Hager, Visante’s SVP of Client Success says, “If you are not acting now, you’re behind.”
The Scope of the Problem: The Disease Burden Is Shifting Fast
The United States is in the midst of a disease burden shift. Meaning, chronic conditions such as diabetes, heart disease, autoimmune disorders, and cancer are not only more prevalent, they are being diagnosed earlier, managed longer, and treated with increasingly sophisticated therapies. According to the CDC, six in ten Americans live with at least one chronic disease, and four in ten have two or more.
Specialty medications—biologics, oncology therapies, gene therapies, and other high-cost complex drugs—now represent a disproportionate share of total drug spend and are projected to continue growing. What was once a niche segment of pharmacy is now the center of gravity. For health systems, this represents a clinical, financial, and operational challenge that demands a proactive response.
The Window Is Open, But Not for Long: Health Systems That Invest Now Will Keep the Patients & the Margin
Health systems that have already invested in specialty pharmacy infrastructure are well-positioned to capture both the clinical and financial value that comes with managing complex patients. Those who haven’t are at risk of watching that opportunity—and those patients—move elsewhere. This fragments care, worsens patient outcomes and allows competitors to gain market share.
Specialty pharmacy isn’t simply about dispensing high-cost medications. Done well, it’s a comprehensive care model that integrates clinical management, access, financial assistance, adherence support and outcomes tracking. When a health system controls that continuum, it retains the patient relationship, captures margin that would otherwise go to outside pharmacies, and delivers measurably better outcomes.
The Cost of Waiting
There’s a tendency in healthcare leadership to approach major operational investments with a “wait and see” posture: evaluating the market, watching competitors, and moving when the path feels clearer. That approach has historically carried manageable risk.
This can no longer be the case. The specialty pharmacy landscape is consolidating rapidly. PBMs, large retail chains, and health plan-owned pharmacies are aggressively competing for this complex patient population. Every day a health system delays building or optimizing its specialty pharmacy capability is time that market share, margin, and patient relationships are becoming more entrenched with other providers.
The health systems winning in this space are not the ones with the largest budgets. They’re the ones that build the right partnerships, put the right infrastructure in place, and align their pharmacy strategy to their broader strategic clinical and financial goals.
Preparing for What’s Ahead
So, as a health system leader, what does it mean to “be proactive” in this environment? At minimum, it means taking an honest look at where your specialty pharmacy capabilities stand today and where the gaps are. Key questions you should be asking yourself:
- Do we have visibility into what our specialty pharmacy market is today and what portion of that market we are keeping in our system?
- Do we have the accreditations and payer contracts necessary to serve all our patients?
- Are our specialty pharmacy services being managed in a way that captures the full clinical and financial value for our organization?
- Do we ensure our 340B program is aligned with our specialty pharmacy strategy—and utilizing the program to expand patient access?
- Is our pharmacy strategy integrated with our broader organizational goals?
The answers to these questions require deep operational expertise, an understanding of evolving payer dynamics, and a partner who can help translate strategy into execution.
The Visante Perspective: We Turn Specialty Pharmacy Complexity into a Competitive Advantage
At Visante, we work alongside health system leaders to assess, build, and optimize specialty pharmacy programs that deliver clinical and financial promise. We don’t arrive with a generic playbook. We act as an extension of your team and bring the expertise, relationships, and implementation experience to help you move with confidence. The question isn’t whether to invest in specialty pharmacy readiness. It’s whether you take action now, or explain later why you didn’t.
Ready to evaluate where your specialty pharmacy program stands? Connect with our team to start the conversation.