The specialty pharmacy & IDN connection

As specialty medications grow more complex and expensive, specialty pharmacies and Integrated Delivery Networks (IDNs) have become central to how life sciences companies drive access, therapy adherence, and long-term product performance.

Specialty medications now account for a growing share of drug spend, pipeline innovation, and commercial growth, particularly across oncology, immunology, neurology, and rare disease. But the success of these therapies depends on far more than prescriber intent. Prior authorization requirements, affordability challenges, site-of-care decisions, and more all influence whether patients actually begin treatment and whether they remain with the therapy long enough to realize a clinical benefit.

At the same time, healthcare delivery has continued to consolidate. IDNs increasingly oversee care across hospitals, physician groups, and outpatient settings. As these systems continue to manage high-cost, high-touch therapies at scale, many are deepening the connection they have with specialty pharmacies, positioning them as more strategic assets rather than simple distribution points.

Whether a specialty pharmacy is in a closely aligned partnership with an IDN or directly owned by one, the dynamic has meaningful implications for life sciences companies. Understanding how the relationship between specialty pharmacies and IDNs work can help you with commercialization, market access planning, and long-term growth.

What is a specialty pharmacy?

A specialty pharmacy is a pharmacy that dispenses high cost and high touch medications that often require special handling or are injectable and treat chronic or complex diseases. These pharmacies also provide patient support beyond dispensing, including adherence support, benefits navigation, and clinical monitoring services to improve clinical and economic outcomes.

According to Definitive Healthcare data, the most common therapy areas covered by specialty pharmacies include oncology, rheumatoid arthritis and autoimmune diseases, neurological conditions, and more.

Unlike commercial pharmacies, specialty pharmacies go beyond merely dispensing medications. They are integral to patient care, offering services such as:

• Medication adherence support: Ensuring patients follow prescribed regimens to improve outcomes.
• Financial assistance: Helping patients navigate insurance complexities or find funding for costly treatments.
• Care coordination: Collaborating with healthcare providers to optimize therapy management.

How do specialty pharmacies fit into IDNs?

Broadly speaking, specialty pharmacies fit into IDNs through two primary models: IDN-owned specialty pharmacies and affiliated or partner specialty pharmacy arrangements.

Each approach reflects different strategic priorities, risk tolerance, and operational capabilities, but both play a central role in how specialty therapies move through the system.

Definitive Healthcare tracks thousands of specialty pharmacies across the U.S. and the hospitals and IDNs they are affiliated. Our HospitalView product offers extensive insights into the facilities that partner or own specialty pharmacies, such as Johns Hopkins Health System, INTEGRIS Health, Mercyhealth, and Penn Medicine.

IDN-owned specialty pharmacies

In an IDN-owned model, the health system owns and operates the specialty pharmacy directly, either as an internal department or through a subsidiary. This enables the specialty pharmacy to be tightly aligned with the system’s clinical pathways, care management processes, and financial goals.

The benefits of this arrangement often include:

• Deeper integration thanks to EHR connectivity and referrals
• Centralized access and intake teams that manage many administrative tasks
• Greater visibility into utilization and outcomes for performance tracking across service lines

For IDNs, ownership typically provides greater control over the specialty therapy journey from prescription to refill, aligning patient care with clinical and population health goals while capturing margins that might otherwise flow to third-party pharmacies, particularly under programs like 340B pricing. For life sciences companies, these pharmacies often act as system-level stakeholders that can influence access pathways, onboarding speed, and real-world therapy performance.

Affiliated and partner models

Not all IDNs own a specialty pharmacy, though. Many rely on affiliated or partner models, working with external specialty pharmacies to deliver services while maintaining clinical oversight within the health system.

In these arrangements, the pharmacy might be integrated with the IDN through preferred referral pathways, service-line agreements, or formal relationships. Partner models allow IDNs to scale out specialty pharmacy services quickly without building the infrastructure needed to dispense medications.

However, the level of integration can vary, and success often depends on how effectively workflows, data, and communication are aligned across organizations. This variability equally applies to life sciences companies, adding uncertainty on who the primary communication touchpoint is and how the IDN influences the rules of engagement.

Why the specialty pharmacy-IDN connection matters

The relationship between the specialty pharmacy and a health system determines how complex therapies move from prescription to patient and real-world impact.

For life sciences companies, this connection shapes the entire performance arc of a medication in the market, influencing access pathways, onboarding speed, adherence and persistence, performance and utilization metrics, and more.

However, finding success in this challenging landscape means engaging with multiple layers of decision-makers. Key stakeholders within IDNs may include C-suite executives, clinical leaders, pharmacy directors, and procurement managers, each influencing different aspects of care delivery and resource allocation.

Moreover, IDNs often have standardized processes and guidelines that dictate how products are evaluated, adopted, and integrated into clinical practice across their facilities. This usually involves demonstrating not only the clinical efficacy and safety of products to P&T committees but also their ability to integrate seamlessly into existing workflows and contribute to the IDN’s overarching goals, such as reducing costs and improving operational efficiency.

In addition, there are a range of important data points you should equip your outreach and sales teams with as you begin to identify and contact IDNs and specialty pharmacies most suitable for your medication. Metrics such as referral patterns, medical and prescription claims volumes, financial performance, clinical metrics, technology adoption, and more are all useful insights for developing an optimal market access strategy.

And by leveraging insights into specialty pharmacies and their relationships with IDNs, you can accelerate the delivery of innovative treatments and devices to the patients who need them most.

For more tips, tricks, and best practices read our how-to guide on engaging IDNs for pharma and biotech companies.

Opportunities for life sciences organizations

Specialty pharmacies can be valuable partners that can help biopharma and medtech companies bring life-changing therapies to market. Here’s how:

Enhancing orphan drug accessibility

Orphan drugs are unlike traditional medications. They target specific conditions affecting small patient groups and require specialized handling, making them inaccessible through traditional corner pharmacies. Instead, these treatments are distributed through specialty pharmacies, which play a pivotal role in delivering these therapies and supporting patient care.

Orphan drugs often face unique hurdles, such as limited patient populations and complex distribution needs. Insights into specialty pharmacy locations, therapeutic focus areas, and IDN affiliations can enable biopharma companies to:

• Optimize clinical trial recruitment by targeting regions with relevant specialty pharmacy networks.
• Streamline the supply chain to ensure timely delivery to niche patient populations.
• Partner with specialty pharmacies for post-market surveillance and patient education.

Supporting long-term management of chronic conditions

Some chronic diseases require sustained therapy adherence over lengthy periods to deliver meaningful outcomes. Understanding how specialty pharmacies support ongoing therapy management allows biopharma companies to:

• Target pharmacies with established adherence and refill management programs.
• Tailor educational and support resources to disease states with known persistence challenges.
• Monitor real-world utilization trends to refine patient engagement strategies over time.

Applying AI to predict access and risk

Specialty pharmacies are increasingly leveraging AI tools and advanced analytics to identify friction points across the therapy journey. Knowing which specialty pharmacies are investing in AI-driven workflows can help biopharma and medtech companies to:

• Identify the pharmacies using predictive models to flag prior authorization delays or high abandonment risk.
• Prioritize partnerships where AI-assisted monitoring supports earlier intervention.

Expanding medtech market reach

For medical device companies, understanding the relationships between IDNs and specialty pharmacies is equally critical. For example, identifying whether a Center of Excellence for a specific therapy is affiliated with a specialty pharmacy can unlock new market opportunities. This knowledge allows medtech companies to:

• Develop targeted strategies for product deployment in high-impact facilities.
• Collaborate with IDNs and specialty pharmacies to integrate devices into existing treatment protocols.

By leveraging specialty pharmacy networks, medtech companies can strengthen their position in markets where devices complement advanced therapeutic solutions.

Learn more

Successfully bringing a specialized therapy to market requires more than strong clinical data or prescriber awareness (though you’ll definitely need both!). The life sciences companies that succeed are those that plan for the full therapy journey, from beginning to end. That means understanding how different IDNs structure specialty pharmacy services, where friction exists, and how system-level decisions influence therapy use at scale.

If you’re looking to bring a new medication or device to market, Definitive Healthcare can help. We help life sciences teams gain visibility by illuminating IDN structures, key healthcare stakeholders, therapeutic focus areas, and more. Book a demo with Definitive Healthcare today to see how we can support your strategy.