OBJECTIVES: Patients with specialty conditions are faced with a unique set of challenges in regard to being adherent to their medications.  One-on-one pharmacist counseling from the comfort of the patient’s home can be an innovative and impactful intervention that can lead to improved adherence for specialty patients.  This study analyzes the impact on adherence after an initial video conferencing session between pharmacist and patient at the start of treatment. METHODS:   Patients new to therapy receiving a video conferencing session from the BriovaRx® specialty pharmacy from April 1, 2013 – May 31, 2014 were included in the analysis.  The comparison group consisted of non-BriovaRx® patients that were also new to therapy during this timeframe and continuously eligible from October 1, 2012 – November 30, 2014.  The two groups of patients were matched on age, gender, and therapy.  Adherence as measured by cumulative medication gap (CMG) was measured for both groups for 180 days after the start of treatment.  The odds ratio was computed to assess the likelihood of a patient having an adherence greater than or equal to 80% with and without the video consultation.  RESULTS: There were a total of 77 patients who received a video consultation and 117 total drug regimens.  The distribution of disease states included: 25% hepatitis C, 22% rheumatoid arthritis, 18% multiple sclerosis and 35% other specialty conditions.  The average age of patients receiving a consult was 46 with 56% female.  The control group consisted of 1,465 patients and 1,736 total drug regimens.   Patients had significantly higher odds of being adherent if they received a video consult (OR=2.04; 95% CI, 1.02-4.07).  CONCLUSIONS: This study highlights the benefit that video consultations can have on the adherence of specialty pharmacy patients.  This is especially important given the high cost and complex management of specialty medications.