How health systems are building specialty pharmacy programs
By Caroline Hudson June 01, 2026
For Chattanooga, Tennessee-based Erlanger, investing in a specialty pharmacy program filled a noticeable care gap across its seven-hospital footprint.
The safety-net health system has many patients with chronic and complex conditions, and it lacked the expertise to give them timely access to specialty medications, President and CEO Jim Coleman Jr. said. After partnering with specialty pharmacy company Shields Health Solutions in 2024, Erlanger built a program that has grown to include treatments in 10 specialties.
“We’ve seen probably double the growth of what we expected as far as patient numbers,” Coleman said.
Related: Cigna banks on specialty pharmacy upside with Shields Health stake
Erlanger isn’t alone in its efforts. Many health systems are embedding specialty pharmacy into their operations to boost revenue, give patients better access to treatments and avoid costly emergency department visits. Many systems are partnering with third-party companies that provide operational support.
“(Systems) that haven’t adopted a strategy or implemented their own specialty pharmacy are trailing the broader industry,” said Brian Flynn, senior managing director at FTI Consulting.
Here’s a look at why — and how — health systems are investing in specialty pharmacy.
What is driving the increase in specialty pharmacy programs?
An aging population and the rise of chronic conditions are driving more demand for specialty drugs. The drugs, administered orally and by infusion, treat complex illnesses such as cancer, neurological disorders and autoimmune diseases.
There are also more specialty drugs available. The Federal Drug Administration approved more than 500 specialty drugs between 2000 and 2024. Since 2012, more than half of FDA approvals each year were for specialty drugs, according to a February study by researchers at Boston-based Tufts Medical Center.
Where do health systems see opportunity?
Specialty pharmacy as a service line boosts revenue and helps offset unprofitable services such as emergency care.
Profit margins on expensive specialty drugs are typically higher than generic treatments. Hospitals that participate in the 340B Drug Pricing Program, which requires drugmakers to offer discounts to some providers, also are more likely to turn a profit.
Specialty pharmacy acts as another access point for patients and extends care beyond hospital walls. One big focus of the programs is ensuring patients stay on their medications. That can lead to better patient outcomes and fewer preventable encounters in costly care settings, saving money for patients, providers and payers.
“Why are we leaving you at the … door as we discharge you from the hospital or emergency room or ambulatory suite,” said Marjorie Lazarre, chief pharmacy officer at Connecticut-based Yale New Haven Health, which launched its program more than a decade ago.
What systems have made recent investments in specialty pharmacy?
Chicago-based Lurie Children’s Hospital, in partnership with Clearway Health, plans to open a specialty pharmacy in July. The more than $1 million, 2,050-square-foot space will be at an outpatient center in Schaumburg, Illinois. It will house a prescription pickup and patient consultation area. Patient liaisons are already embedded in clinics to help with prior authorization requirements.
Med Center Health said in April it is establishing a program in Bowling Green, Kentucky. Services are being offered at its neurology, heart and lung and gastroenterology clinics, with plans to expand into additional clinics.
Also in April, Columbus Regional Health in Columbus, Indiana, said it launched specialty pharmacy services for cardiology, pulmonology, oncology and gastrointestinal patients.
Yale New Haven is opening a 50,000-square-foot specialty pharmacy site in West Haven, Connecticut, in 2028 that will house fulfillment services and retail pharmacy. The facility will have robotics and automation capabilities, said Vinay Sawant, system executive director of specialty, retail and home infusion services. The system did not provide an investment cost. Yale New Haven’s pharmacy provides treatment for nearly 100 specialized diagnoses.
How do partnerships play a role?
Many health systems with limited resources turn to third-party companies for support in building, expanding and/or maintaining specialty pharmacy programs. The companies bring expertise in navigating payer contracts, implementing technological tools, earning accreditation and managing new medications.
“Specialty pharmacy is wildly complex, and it’s so unique for every single hospital and health system because it has to be localized,” said Allison Arant, senior vice president of client development and marketing at Clearway Health, which spun out from Boston Medical Center Health System.
Companies such as Clearway, which works with 13 hospitals and health systems, and Shields, which has about 75 health system partners, embed pharmacists, pharmacy technicians and pharmacy liaisons into day-to-day operations to work alongside system employees.
The model incentivizes both partners to deliver results, said Robert DiGregorio, chief pharmacy officer of pharmacotherapy services at the Brooklyn Hospital Center in New York, which partnered with Clearway.
“We felt that we had an insurance policy, if you will,” DiGregorio said. “If we weren’t growing, then they were not going to benefit either.”
Are the partnerships paying off?
Health systems say they are seeing operational improvements through their partnerships.
The Brooklyn Hospital Center has quadrupled prescription volumes to about 400 prescriptions per day since adding specialty pharmacy, DiGregorio said. The center’s specialty pharmacy in the main hospital earned accreditation in 2024.
Erlanger’s Coleman said administrative support from Shields saved clinicians 2,950 hours over a three-month period on handling prior authorizations, claim denials and other tasks.
Lurie Children’s is processing prescriptions faster, said Jenny Elhadary, vice president of clinical services. The hospital’s turnaround time is about two days, well below the seven-day national average, she said.