Is Specialty Pharmacy Management Frozen?

Someone asked me an interesting (but I suspect somewhat rhetorical) question last week.  They asked if I had seen meaningful innovation in specialty pharmacy management in the past 5 years beyond simply increased automation.  It immediately made me think of this picture of Hans Solo frozen in time.

I had to say no.

Specialty has been focused on leveraging the PBM lessons from the past decade and implementing them.  How to manage spend?  How to get rebates?  How to push generics?  How to implement technology?  How to distribute drugs more efficiently?  What are the right plan designs?

Do you disagree?

I think the one area where you could easily argue is around pharmacogenomics.  This is an interesting one since it will have a big effect on specialty medication and you have two of the big 3 PBMs (Medco and CVS Caremark) who have embraced it while you have Express Scripts talking a little about it.  They seem to be taking a wait and see approach until it is clear how they make money in this space.