Report Outlines Steps to Manage High-Cost Specialty Drugs as Costs Rise
Benefit manager cites 19% increase in specialty spending last year (October 10)
According to a report from pharmacy benefit manager Prime Therapeutics LLC, rising costs and the increased use of specialty drugs are placing a greater financial burden on people, their employers, and their health plans.
Spending on high-cost specialty drugs used to treat complex diseases, such as cancer, increased more than 19% among Prime Therapeutics members in 2012. That increase differs greatly from the company’s 0.9% drop in traditional (all non-specialty) drug spending in 2012.
The new report outlines seven steps for employers and health plans to take control of specialty drug costs. These steps are:
- Bridge the benefit divide: Use combined pharmacy and medical benefit data to see the full scope of specialty spending and seek solutions.
- Focus on the biggest issues: Use combined data to target the most urgent issues and focus on the areas that can provide the greatest return on investment.
- Narrow the specialty networks: Use cost-effective distribution channels and limit the number of distributors to secure lower costs.
- Embrace a management mindset: Make sure the right specialty drugs are used properly by those who will benefit the most.
- Promote preferred drug use: Build plans that encourage desired behaviors.
- Protect members from high costs: Limit members’ out-of-pocket costs and use available tools to reduce the burden on highly vulnerable members.
- Pick the right partner: Select a trusted advisor with comprehensive capabilities and deep connections to help anticipate and address specialty drug challenges.
According to the report, specialty drugs account for 30% of total drug costs, and that number is expected to reach 50% of total drug spending by 2018.
Source: Prime Therapeutics; October 10, 2013.