Scope and Characteristics of Patients Filling Medications Through Specialty Pharmacies by Ownership Type

Using Colorado all-payer claims data, the authors found that while only 0.8% of insured patients filled medications at specialty pharmacies, these users were older, more often female, more socially vulnerable, and had significantly higher prescription use than other patients. Vertically integrated specialty pharmacies accounted for most fills, and their users exhibited higher social vulnerability and more complex medication needs, suggesting that legislation banning PBM or insurer ownership of specialty pharmacies could disproportionately disrupt patient access.