Specialty Pharmacy Gets Even Hotter After Cigna Investment And Peak Rock’s Asembia Buy
News that Cigna’s Evernorth has committed $100 million to support a new artificial intelligence-powered pharmacy program and a private equity firm has acquired Asembia are only the latest in a wave of big investments in specialty pharmacy.
And they won’t be the last as health insurers, private equity firms, medical care providers and others look to grab a piece of one of the fastest growing and lucrative areas of the healthcare industry. Specialty drugs come from the wave of new biologic medicines and other prescriptions not dispensed in the traditional pharmacy like pills, capsules and tablets typically picked up at Walgreens or CVS Health drugstores.
Already, billions of dollars have been invested by companies and firms in expanding specialty pharmacy in just the last two years by some of the biggest names in healthcare including Cigna, Humana, CVS, Elevance Health and UnitedHealth Group.
Specialty drugs account for well more than half of the total prescription spending any health plan, employer or government health program manages. And employer clients tell benefits consultants specialty costs easily account for 60% or more of their total drug spending, particularly as more Americans flock to anti-obesity GLP-1 medicines, prescriptions hailed for their ability to help people lose weight.
“Patients navigating complex health conditions need comprehensive, expert support, often during some of the most difficult moments in their lives,” Matt Perlberg, president of the Evernorth Health Services pharmacy and care delivery businesses said of the healthcare giant’s new “Pharmacy Forward” program.
“The program is supported by a $100 million investment through 2028,” Cigna said in announcing the investment last week. “This investment enables care teams to focus more on clinical care and patient outcomes while reducing prescription processing timelines and improving service responsiveness.”
It’s only the latest specialty pharmacy investment by Cigna. Last year, Cigna’s Evernorth invested $3.5 billion in Shields Health Solutions, which operates specialty pharmacies in hospitals and health systems across the U.S.
Shields was one of Walgreens’ most lucrative businesses, partnering with more than 80 health systems comprised of more than 1,000 hospitals and clinics across nearly all 50 states. Evernorth’s investment in Shields was announced not long after the company was sold to private equity firm Sycamore Partners in the $10 billion takeover of Walgreens.
Evernorth operates the large pharmacy benefit management company Express Scripts and Accredo specialty pharmacy, which includes home delivery of complex medical conditions and has nurses who do in home and ambulatory infusion services.
Other health insurers with large healthcare services businesses have also made substantial investments in specialty pharmacy. Elevance Health, operator of Blue Cross and Blue Shield plans in 14 states, in 2024 acquired Paragon Healthcare, Inc., a provider of infusion services to patients. And that deal came a year after Elevance closed on its acquisition of BioPlus, a specialty pharmacy.
Meanwhile, Humana, known for providing millions of seniors health insurance via the Medicare Advantage plans it sells, has made big investments expanding its CenterWell specialty pharmacy business.
Private equity, too, is targeting specialty pharmacy. Though financial terms of Peak Rock Capital’s purchase of Asembia weren’t disclosed last week, the deal is believed to be sizable. Peak Rock says it makes investments in the range of $50 million to $1.5 billion.
Asembia is a fast-growing provider of services surrounding specialty pharmacy including distribution, group purchasing and technology connecting patients. Asembia also provides yet another measure of the growth of specialty pharmacy given the massive annual AXS26 Summit that the company and the Irene family have hosted for more than 20 years.
The event, which drew two dozen Asembia executives and clients to its first meeting, was attended by nearly 10,000 this year over four days at Wynn & Encore Las Vegas including more than 1,500 attending businesses and other organizations from around the world.
In the press release announcing its acquisition of Asembia, Peak Rock executives indicated this wouldn’t be their last deal in the specialty pharmacy space.
“We are excited to partner with the Irene family, Asembia management, and employees to invest in technology, capabilities, marketing, and other growth initiatives to support the company in serving more patients, prescribers, pharmacies, and pharma manufacturers,” Peak Rock managing director Spencer Moore said. "We plan to also pursue complementary acquisitions that will support accelerated growth."