Our Founder & CEO, Joe Cardosi, sits down with Sarah Marche, Sr. Vice President of Pharmacy Services at Highmark Inc., and Robin Goldsmith, host of Healthcare on Air by Verizon to discuss the complexities of the specialty pharmacy ecosystem – and how FMH and Highmark’s innovative partnership is improving the specialty pharmacy experience for Highmark members.

Here are six key themes from the conversation:

In Pittsburgh, we’re reimagining specialty pharmacy right where it began.

The steel city is known as the birthplace of specialty pharmacy. In this conversation, we discuss how specialty pharmacy got its start and the current landscape today.

Specialty drugs are defined by:

• High cost
• Complex administration
• Treatment for life-altering, chronic conditions

While specialty drugs make up only about 2% of prescriptions, they drive nearly 50% of total drug spend, and utilization only continues to grow. This makes specialty pharmacy one of the most important and most challenging areas of healthcare today.

The specialty medication journey is complicated and frustrating.

Unlike traditional prescriptions, the specialty medication fulfillment process is often anything but seamless. There are process missteps, misdirected interactions, and confusion that lead to delays in treatment. Patients often become their own care coordinators during some of their most vulnerable moments of the journey.

The root problem isn’t just cost. It’s fragmentation.

While affordability dominates the headlines, the deeper issue is system fragmentation.

Not all pharmacies have access to the same drugs, and some specialize in specific disease states. Throughout the process, the coordination of a patient’s care can be inconsistent. This creates inefficiencies that delay treatment and increase drug abandonment rates.

A marketplace approach enables pricing transparency and better patient care – all while streamlining the process.

The FMH platform connects patients with the best-fit pharmacy based on clinical needs, leverages competition across pharmacies for improved affordability, and uses technology to streamline coordination and visibility, compared to legacy models with a “one-size-fits-all” approach.

Real results: better access, lower costs, and improved outcomes.

According to a recent analysis by Highmark, our partnership is delivering measurable impact:

• 2-4 days faster start to therapy
• Improved medication access rates by more than 50 percent
• Better cost savings

Innovation isn’t always easy. It requires risks.

Launching this model came with its own set of challenges to drive innovation in a highly regulated, risk-averse space of healthcare.

• It challenged the status quo for payers
• It required new ways of thinking

FMH and Highmark’s partnership shows how deep industry expertise and a willingness to rethink legacy models can drive meaningful transformation in the specialty pharmacy ecosystem. This discussion underscores a broader shift toward innovation to remove systemic barriers and to focus on what ultimately matters most: the patient.

Listen to the full episode here:

Apple Podcast

Spotify Podcast