How specialty drugs are acquired / Overview


Buy-and-Bill icon
  • Acquisition method under the medical benefit

    • for drugs administered in the provider's office or alternate site of administration

    • drugs covered under Medicare Part B must be acquired through buy-and-bill

  • As more innovative specialty drugs and biologics are introduced, buy-and-bill is growing in use in immunology, ophthalmology, rheumatology, dermatology, and neurology, in addition to being a predominant acquisition method in oncology

Specialty pharmacy2

Specialty Pharmacy icon
  • Predominant acquisition method under pharmacy benefit for self-administered prescription drugs

  • PBMs may be in charge of utilization management such as step therapy

It is important to understand the intricacies of each acquisition
method and the potential impact to your patient's treatment.

Click to learn and compare how the different acquisition methods work for patients with Medicare or commercial insurance.

References: 1. Fein AJ. Published October 14, 2016. Accessed June 21, 2020. 2. Fein AJ. Published July 2016. Accessed June 21, 2020.