Specialty Pharmacy and High-Cost Medications

This dataset provides a detailed record of specialty pharmacy management for high-cost medications, including patient demographics, medication types, prescriber details, prior authorization status, financial assistance enrollment, and adherence support. It enables analysis of treatment patterns, cost management, and patient outcomes for biologic and oncology therapies, supporting both clinical and operational decision-making.

  • last updated 2 Nov 2025
  • by GoMask
The brief that made it

Specialty drug utilization and cost analysis

Sample rows

preview · 8 of 100 rows · all 32 columns
patient_idstringmedication_typestringmedication_costfloatprior_authorization_requiredbooleanpatient_assistance_program_namestringpatient_first_namestringpatient_last_namestringpatient_date_of_birthdatepatient_genderstringpatient_phonestringpatient_emailstringaddress_streetstringaddress_citystringaddress_statestringaddress_postal_codestringaddress_countrystringmedication_idstringmedication_namestringprescription_datedateprescriber_idstringprescriber_namestringprescriber_specialtystringprior_authorization_statusstringbuy_and_billbooleanpatient_assistance_program_enrolledbooleanadherence_support_providedbooleanadherence_scorefloattreatment_start_datedatetreatment_end_datedatetreatment_outcomestringdiagnosis_codestringdiagnosis_descriptionstring
PAT001_AZbiologic2389.56trueAbbVie Patient AssistanceJamesAnderson1968-02-14male+1-602-555-0178j.anderson68@gmail.com1543 S 8th AvePhoenixAZ85003USAMED202401Humira2024-04-15DR0001Dr. Helen Tranrheumatologyapprovedtruetruetrue93.22024-04-20blankongoingM05.79Rheumatoid arthritis with involvement of other organs and systems
PAT002_TXoncology5610trueblankMariaGutierrez1980-07-03female+1-210-555-7382m.gutierrez80@yahoo.com882 E Commerce StSan AntonioTX78205USAMED202402Keytruda2024-03-30DR0002Dr. Rajiv Pateloncologyapprovedfalsefalsetrue89.62024-04-05blankongoingC34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
PAT003_ILbiologic1945.2falseJanssen CarePathGraceChoi1995-11-19female+1-312-555-8621grace.choi95@outlook.com501 W Adams StChicagoIL60661USAMED202403Remicade2024-04-01DR0003Dr. Mark Levinegastroenterologynot_requiredtruetruefalseblank2024-04-03blankongoingK50.10Crohn's disease of small intestine without complications
PAT004_CAbiosimilar1350.85trueblankRobertKing1972-04-28male+1-415-555-1836robking1972@gmail.com2310 Lombard StSan FranciscoCA94123USAMED202404Neulasta2024-02-18DR0002Dr. Rajiv Pateloncologyapprovedfalsefalsetrue97.82024-02-212024-05-15improvedD70Agranulocytosis
PAT005_NYoncology4230trueNovartis Oncology PAPSofiaMartinez1962-09-22female+1-212-555-7619s.martinez62@aol.com118 W 72nd StNew YorkNY10023USAMED202405Gleevec2024-06-07DR0004Dr. Susan Linhematologypendingfalsetruetrue85.42024-06-12blankongoingC92.10Chronic myeloid leukemia, BCR/ABL-positive
PAT006_FLbiologic1800.5trueblankWilliamEvans1985-05-27male+1-305-555-4792bill.evans85@icloud.com401 SW 8th StMiamiFL33130USAMED202406Enbrel2024-03-14DR0001Dr. Helen Tranrheumatologyapprovedtruefalsetrue80.12024-03-18blankongoingM06.9Rheumatoid arthritis, unspecified
PAT007_MAoncology5120trueblankAvaNguyen2001-12-06female+1-617-555-3412ava.nguyen01@gmail.com22 Beacon StBostonMA02108USAMED202407Herceptin2024-05-09DR0005Dr. Laura Williamsoncologyapprovedfalsefalsefalseblank2024-05-14blankongoingC50.911Malignant neoplasm of unspecified site of right female breast
PAT008_WAoncology3985.7trueblankHenryLee1949-03-10male+1-206-555-6601hlee1949@hotmail.com1201 E Pike StSeattleWA98122USAMED202408Rituxan2024-01-26DR0004Dr. Susan Linhematologyapprovedtruefalsetrue75.32024-02-012024-05-22completedC85.80Other specified types of non-Hodgkin lymphoma, unspecified site

What the 100 rows show

from the 100-row sample

Oncology (medication type) stands out: mean medication_cost is 8,907, against 2,199 for the rest.

  • 63%prior_authorization_required = true
  • 2,401median medication_cost
  • 2patient genders
  • 4prior authorization statuses
  • 4treatment outcomes
  • 7prescriber specialties
Mean medication_cost by medication_type100 rows
05,00010k2,093biologic45 rows8,907oncology40 rows1,287biosimil…12 rows7,442other3 rows
medication_cost100 rows, in bands of 2,500
030605112101286001012.5k22.5kmedication_cost →

Median 2,401, from 650.0 to 21,000.

patient_assistance_program_name50 rows with a value · 50 left blank
  1. Genentech Access Solutions10
  2. Janssen CarePath6
  3. Novartis Oncology PAP4
  4. Novartis Patient Assistance4
  5. AbbVie Patient Assistance3
  6. Bristol-Myers Squibb Access3
  7. Janssen Oncology Access2
  8. Pfizer Oncology Together2
  9. Sanofi Patient Connection2
  10. Amgen Safety Net Foundation2
32 columns by typefrom the column list below
  • string 22
  • float 2
  • date 4
  • boolean 4

Columns

32 columns in four groups
blueprint · 32 columns
columntypedescriptionexample
Text 22 columns
patient_idstringUnique identifier for each patient receiving specialty medicationuniquePAT001_AZ
patient_first_namestringPatient's first nameJames
patient_last_namestringPatient's last nameAnderson
patient_genderstringPatient's gendermale · female · other · unknown · optionalmale
patient_phonestringPatient's contact phone numberoptional+1-602-555-0178
patient_emailstringPatient's email addressoptionalj.anderson68@gmail.com
address_streetstringPatient's street addressoptional1543 S 8th Ave
address_citystringPatient's cityoptionalPhoenix
address_statestringPatient's state or provinceoptionalAZ
address_postal_codestringPatient's postal or ZIP codeoptional85003
address_countrystringPatient's countryoptionalUSA
medication_idstringUnique identifier for the specialty medicationMED202401
medication_namestringCommercial or generic name of the medicationHumira
medication_typestringType of specialty medication (e.g., biologic, oncology, biosimilar)biologic · oncology · biosimilar · otherbiologic
prescriber_idstringUnique identifier for the prescribing healthcare providerDR0001
prescriber_namestringName of the prescribing healthcare providerDr. Helen Tran
prescriber_specialtystringMedical specialty of the prescriber (e.g., oncology, rheumatology)7 specialties · optionalrheumatology
prior_authorization_statusstringStatus of the prior authorization (e.g., approved, pending, denied)approved · pending · denied · not_required · optionalapproved
patient_assistance_program_namestringName of the patient assistance program, if enrolledoptionalJanssen CarePath
treatment_outcomestringOutcome of the specialty drug treatment (e.g., ongoing, completed, discontinued, improved, no_change)6 values · optionalongoing
diagnosis_codestringPrimary diagnosis code (e.g., ICD-10) for which the specialty medication is prescribedM05.79
diagnosis_descriptionstringDescription of the diagnosisoptionalAgranulocytosis
Numbers 2 columns
medication_costfloatCost of the medication per unit or treatment cycle0 or more2389.56
adherence_scorefloatScore or percentage indicating patient adherence to medication regimen0 to 100 · optional93.2
Dates and times 4 columns
patient_date_of_birthdatePatient's date of birth1968-02-14
prescription_datedateDate the medication was prescribed2024-04-15
treatment_start_datedateDate when the patient started the specialty medicationoptional2024-04-20
treatment_end_datedateDate when the patient ended the specialty medication (if applicable)optional2024-05-15
True or false 4 columns
prior_authorization_requiredbooleanIndicates if prior authorization is required for the medicationtrue
buy_and_billbooleanIndicates if the medication is managed under buy-and-bill processoptionaltrue
patient_assistance_program_enrolledbooleanIndicates if the patient is enrolled in a patient assistance programoptionaltrue
adherence_support_providedbooleanIndicates if adherence support was provided to the patientoptionaltrue

Use it for

  • prior authoriz…63%63 of 100 rowsmean medication cost …2.1kbiol…8.9konco…1.3kbios…7.4kother

    A healthcare dashboard

    The prior_authorization_required rate, medication_cost by medication_type and a breakdown of patient_assistance_program_name. Excel, Power BI or Tableau.

  • Why do the 40 oncology rows have a mean medication_cost of 8,907?

    A root-cause class exercise

    Hand out the rows and one question. The answer is in the data, not in the brief.

  • A software demo

    Believable patients with patient_first_name, patient_last_name and patient_date_of_birth to fill a screen in front of a buyer.

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This dataset100 rows32 columns
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blueprint · specialty-pharmacy-and-high-cost-medications

Behind this dataset

Same schema. As many rows as you need.

These 100 rows came out of a blueprint — 32 columns with generation rules behind each one. Open it in Data Factory to retune a column, add your own, wire in foreign keys, and run it at the size you actually need.

Rules it was built with
  • Drug categorized as specialty (high-cost, complex dosing, monitoring)
  • Examples: biologics, oncology, MS, HIV, hepatitis C, rare disease
  • Specialty pharmacy channel required
  • Prior authorization mandatory for most specialty drugs
  • Patient assistance programs (PAP) for uninsured or financial hardship
  • Copay assistance cards and manufacturer coupons
  • Buy-and-bill model for physician-administered drugs
  • J-code billing for infused or injected specialty drugs
Rows
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Exports
CSV, JSON, JSONL, Parquet, SQL, Excel, TSV, XML
Licence
yours to use, including commercially
API slug
specialty-pharmacy-and-high-cost-medications

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