2024’s money moves: Healio Rheumatology tracks specialty pharmacies, work-life balance

Money talks. And in the world of medicine, what it has to say has important implications for patients and providers alike.

Throughout 2024, Healio Rheumatology has followed the business trends impacting the specialty, from the proliferation of biosimilars to the explosion of in-house specialty pharmacies. We have also kept tabs on the evolving understanding of work-life balance amid a rheumatology workforce shortage projected to worsen in years to come.

We devoted significant coverage to the American College of Rheumatology’s efforts to bolster private practices and help them navigate increasingly unfriendly economics. And over the summer, we shined a light on the lack of pediatric rheumatologists, highlighting the struggles of families who are hundreds of miles away from the nearest specialist.

Keep reading to explore this year’s coverage.

Mark Cuban’s Cost Plus Drug Company ‘flying under the radar’ after 2 years

The Mark Cuban Cost Plus Drug Company launched in January 2022 to a flurry of promises, curiosity, and a certain guarded optimism among experts regarding its potential to lower medication prices for patients.

Two years down the line, the company, helmed by billionaire entrepreneur and Dallas Mavericks minority owner Mark Cuban, has had both slam dunks and airballs. Read more.

‘Devouring’ the market? Walmart to quintuple its autoimmune specialty pharmacy locations

The largest retailer in the nation has sampled a taste of the autoimmune specialty pharmacy market, and has decided it wants more.

Walmart this past summer announced that it will open 25 new autoimmune-focused “specialty pharmacies of the community” across five states, bringing its total of autoimmune specialty pharmacies to 31 across nine states. Read more.

‘Do not hesitate to seek help’: Balancing business, patient care in private practice

Private practice rheumatologists face an increasing array of challenges as large, corporate and academic health systems become the norm for medical care, threatening to bump smaller entities aside.

In response, the American College of Rheumatology has established the Community Practice Council, a group of private practice providers tasked with defining this array of challenges and providing solutions where possible. Read more.

‘You can have much more control’: The rise of in-house specialty pharmacies

From 2011 to 2019, the proportion of rheumatologists who reported using in-house pharmacies exploded, from 4% to 22% — a more than fivefold increase.

These findings, published earlier this year in JAMA Network Open by Pragya Kakani, MD, and colleagues, originate from a cross-sectional study of data from more than 8 million patients, including 20% of all beneficiaries enrolled in fee-for-service Medicare Parts A, B, and D. Their results additionally pointed to similarly striking expansions for in-house pharmacy use beyond rheumatology practices, including a more than twofold increase in oncology, a fourfold increase in gastroenterology, and a staggering 20-fold increase in urology. Read more.

‘We cannot pour from an empty cup:’ Work-life balance takes priority for today’s providers

When it comes to work-life balance, providers in the past skewed more toward work than life.

However, shifting demographics in the medical workforce, increasing capacity for communication and the COVID-19 pandemic have fundamentally altered that calculus. Read more.

‘Nobody else to see’: Families trek hundreds of miles for pediatric rheumatology visits

“Your foot is very swollen. Like, there’s definitely something really wrong with your foot.”

That is what 17-year-old Estelle LeBoeuf remembers her teammates saying years ago, when, at just 9 years of age and deeply involved in gymnastics, she began to demonstrate symptoms. By the time she finally received a diagnosis — juvenile rheumatoid arthritis — doctors had put her into boots and casts so many times that she ultimately lost a degree of foot mobility, which she has yet to fully regain. Read more.

Drug costs and nocebo risks: Navigating the Humira ‘biosimilar boom’ 1 year later

A lot can change in a year. But has it?

The first Humira biosimilar hit the U.S. market a little over a year ago. Since then, a total of nine biosimilars for Humira (adalimumab, AbbVie) have launched, including two with interchangeable status. Read more.