Specialty Pharmacy Trends in 2026
Key developments shaping biologic access, biosimilar adoption, and specialty pharmacy services
Key Trends at a Glance
- GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) are driving the largest category expansion in specialty pharmacy history
- Biosimilar adoption is accelerating as PBM formularies shift and prescribers gain familiarity
- AI-assisted prior authorization is beginning to reduce approval times across major insurers
- Home infusion services are expanding as patients seek alternatives to infusion center visits
- Specialty pharmacy consolidation continues as health systems and PBMs expand their pharmacy operations
1. GLP-1 Medications: The Fastest-Growing Specialty Category
The explosive growth of GLP-1 receptor agonists — Ozempic, Wegovy, Mounjaro, and Zepbound — has fundamentally expanded what specialty pharmacy means. These injectable medications for diabetes and weight management require cold-chain handling, clinical monitoring, dose titration support, and insurance navigation — all core specialty pharmacy competencies.
Insurance coverage for GLP-1 medications remains inconsistent, particularly for weight management indications. Prior authorization requirements, step therapy protocols, and coverage denials are common — making specialty pharmacy support essential for patients accessing these medications.
2. Biosimilar Market Maturation
The adalimumab (Humira) biosimilar market has demonstrated that biosimilar adoption in the US follows a different trajectory than in Europe — slower, more formulary-dependent, and heavily influenced by manufacturer rebate strategies. However, the broader biosimilar market is maturing. As prescriber familiarity grows and PBM formularies evolve, biosimilar penetration is expected to increase across all major biologic categories.
3. AI in Prior Authorization
AI-powered prior authorization tools are beginning to automate parts of the PA process — reducing documentation burden, flagging incomplete submissions before they reach the insurer, and in some cases enabling real-time automated approval for straightforward cases. Several major insurers have implemented AI-assisted PA review platforms. The impact on specialty pharmacy operations and PA turnaround times is expected to grow significantly through 2026 and beyond.
4. Home Infusion Expansion
The availability of subcutaneous formulations for medications previously available only as IV infusions (Entyvio SC, Remicade subcutaneous biosimilars, Orencia SC) has expanded home-based treatment options. Combined with growth in home infusion nursing services, more patients are accessing IV biologics in the home setting — a trend accelerated by the COVID-19 pandemic that has continued to grow.
5. What This Means for Patients
More Options
Biosimilar competition and subcutaneous formulation availability mean more choices — and BiologicHealthPlus helps you navigate them to find the best fit for your plan.
Faster PA
AI-assisted prior authorization is beginning to reduce average approval times. BiologicHealthPlus tracks PA technology advances to stay ahead of insurer system changes.
Better Access
Home infusion expansion means some patients who previously needed clinic visits can now receive certain IV biologics at home.
Continued Complexity
Insurance complexity continues to grow. BiologicHealthPlus remains your expert guide through prior authorization, formulary navigation, and copay programs.
✅ BiologicHealthPlus Stays Ahead of Every Trend
Our pharmacists continuously monitor formulary changes, new biosimilar launches, and PA policy updates — so your access to biologic medications is never interrupted.
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Content developed with reference to leading health organizations, peer-reviewed research, and FDA prescribing information.
Medical Disclaimer: Educational content reviewed by the BiologicHealthPlus Clinical Team. Consult your healthcare provider for personalized advice. Last reviewed: August 2026.