In this interview, John Colaizzi, Jr., PharmD, vice president and head of enterprise pharmacy practice at Walgreens, shares insights on the evolving role of specialty pharmacy networks and their strategic placement near Centers of Excellence and Key Opinion Leaders (KOLs). Dr Colaizzi discusses how this proximity improves therapy access, streamlines care coordination, and enhances outcomes for patients with rare and complex conditions.

Please introduce yourself by stating your name, title, organization, and relevant professional experience.

John Colaizzi, PharmD: I'm John Colaizzi. I’m vice president and head of enterprise pharmacy practice at Walgreens, where I’ve spent the past nearly 29 years. I started my career as a pharmacy tech, and then I practiced pharmacy for a number of years. I spent some years in our traditional community pharmacy practice, and I’ve been part of Walgreens specialty since day one. We operated our first specialty pharmacy back in 2006, and I had a part in that.

I’ve had several roles in our specialty pharmacy organization, including leading the Walgreens specialty operations team. This team is responsible for maintaining the integrity of pharmacy practice across all of our lines of businesses—everything from our traditional pharmacies to our specialty pharmacies to our central fill facilities. We are responsible for our patient safety organization, our compliance operations, our accreditations, and all of the work we do with the pharmacy practice industry. This includes the work we do with boards of pharmacy and pharmacy associations, and schools and colleges of pharmacy.

I also work externally on behalf of the profession. I currently sit on the New Jersey Board of Pharmacy, and I’m a member of the Board of Directors of the National Association of Specialty Pharmacies.

How do proximity-based pharmacy networks—particularly those near Centers of Excellence and KOLs—specifically improve the timeliness of therapy initiation for patients with rare diseases?

Dr Colaizzi: Pharmacy, in general, is widely known as the most accessible health care provider. About 90% of Americans live within 5 miles of a pharmacy. Pharmacists have been able to build a massive amount of trust with the public. In fact, pharmacists are among the most trusted professions. If you look at the most recent Gallup survey, pharmacists were found to be even more trusted than medical doctors. However, providing specialty care where medical care is being delivered has not been the traditional specialty pharmacy model. Much of specialty pharmacy has been centralized, for good reason. The care that is provided for specialty patients and specialty products typically require a much higher-touch care, more training, more specialized handling of those products.

During our panel at Asembia, we discussed how we can bring together the best of both worlds in providing specialty care. Providing specialty care in proximity to medical care can have advantages, but how do we provide the same levels of support as the traditional pharmacy model? First, we need to consider access and affordability. Ensuring broad access to specialty therapies and maintaining affordability are critical priorities in specialty pharmacy, particularly when you're providing it locally to where care is being provided and local to key opinion leaders (KOLs). Patients should never be delayed or denied treatment due to these logistical or financial barriers that occur within specialty pharmacy on occasion.

On the panel, we had a cross section of all stakeholders in the continuum of specialty care. We had Brian Smith, PharmD, chief pharmacy officer, Shields Health Solutions; Neera Clase, senior vice president of Market Access, Tarsus Pharmaceuticals; and Jamie Bond, PharmD, manager, Community-Based Specialty Pharmacy at Walgreen. Neera provided the manufacturer perspective on the topic, and Jamie provided the clinician perspective on how she provides specialty care for her patients in the greater Las Vegas area. The theme of our discussion was how we bring together the proximity and trust that patients have with their pharmacists with the high-touch care that specialty pharmacy is expected to provide to these patients.

Can you elaborate on how partnerships between pharmacies and providers streamline the prior authorization process, and what quantifiable impact this has had on access to therapy or patient outcomes?

Dr Colaizzi: Specialty pharmacy should be local to the patient and local to the care team. Deep integration with health care systems and providers is essential. For example, at Shields they have pharmacy liaisons that are embedded within clinics to help bridge the care and pharmacy services. On the Walgreens side, about 70% of physicians are located within 25 miles of a Walgreens community-based specialty pharmacy, and they're backed by the Walgreens Centralized Specialty Pharmacy. So, you've got this unique combination of 300 fully accredited community-based specialty pharmacies embedded within the communities they serve, backed by the scale and capabilities of the Walgreens Central Specialty Pharmacies.

We believe that services should be available to every patient, ensuring access to the most affordable therapy options and supporting the entire care journey, from the initial prescriptions to long-term therapy management. It's also important to look at the challenges that the provider community is seeing and how pharmacy can help. Provider burnout is at an all-time high right now. They face multiple competing priorities and limited bandwidth. Systems should be designed to ease that burden, not add to it, particularly around the idea of prior authorizations. Proximity to care and the localized specialty pharmacies can often assist with overcoming those burdens. We are seeing significant benefits in these localized models for improved turnaround time and improved ability to manage the prior authorization process faster and reduce cost of care for the patients.

What role do specialized pharmacies embedded within hospitals or health systems play in bridging gaps in continuity of care, especially during care transitions such as post-discharge?

Dr Colaizzi: Delivering therapy to patients quickly helps minimize that progression of disease. Proximity to care in these models and early intervention can reduce the risk of hospitalization and other serious complications. Delays in care often can lead to a loss in patient engagement and decreased adherence. So, continuous support is essential throughout the entire care journey, from diagnosis to ongoing therapy.

Patients and providers are very loyal to their pharmacy care team. In our panel, Jamie talked about how she goes into the community every week and meets with the prescribers and KOLs that she works with. This is not common in the traditional specialty pharmacy model where the providers know their specialty pharmacy face-to-face. The pharmacists are accessible to patients for education, counseling, and adherence support. If the patient prefers to have an in-person consultation with their pharmacist, the localized specialty pharmacy model can allow for that. The proximity—being embedded either in or near the point of care—enables faster intervention and more personalized service. It also allows for a stronger provider-pharmacy relationship that creates opportunities to further deliver care in a coordinated and timely manner.

Looking forward, how do you envision the role of these integrated pharmacy networks evolving in the next 3–5 years, particularly in response to ongoing changes in payer models and rare disease therapies?

Dr Colaizzi: There's an old saying: You have to skate to where the puck is going, not to where it is right now. Specialty pharmacy is doing this relative to where the industry is moving. If you look at the drug pipeline, it is majority specialty medications and novel gene therapies. Since high-touch, patient-centered support is essential, this will only become more important with the emerging pipeline.

One example of an early innovation is that Walgreens opened a gene and cell services pharmacy and innovation center last year. It is a dedicated, state-of-the-art 18 000 sq ft facility in Pittsburgh, Pennsylvania, with services and capabilities for these emerging therapies, including innovative solutions for managing the complexity of the supply chain, logistics, and financing, as well as the clinical and social needs required to ensure success for these gene therapy patients and partners.

Our centralized operations can accommodate the special needs of virtually any complex therapy. The established relationships we have in the community provide a direct line to connect manufacturers, providers, and patients with local gene and cell treatment centers, including clinical expertise and operational support. It's important that the industry continues to work together across all of the stakeholders to identify how pharmacy care can support the needs of these emerging therapies.