7 steps for managing costs of specialty drugs

October 10, 2013

Patients, employers, and health plans are continuing to be burdened by the rising costs and use of specialty drugs. However, employers and health plans can control specialty drug costs more easily with the help of Prime Therapeutics’ new report.

Patients, employers, and health insurance plans are continuing to be burdened by the rising costs and use of specialty drugs. However, employers and health plans can control specialty drug costs more easily with the help of Prime Therapeutics’ new report.

In “Specialty: Today & Tomorrow,” the pharmacy benefit manager (PBM) offers 7 steps that health plans can use to rein in these rising costs.

1) The report recommends the use of pharmacy and medical benefit data to understand the scope of specialty spending.

2) The report said that the use of combined data helps to focus on the greatest issues, which can provide the greatest return on investment.

3) Another recommendation is the use of narrower specialty networks, which limits the number of distributors and secures a better, lower price for the drugs.

4) Ensure that the right specialty drugs are used correctly by the individuals who can benefit the most.

5) Design a benefit specialty drug plan that promotes preferred drug use.

6) Help members by limiting their out-of-pocket costs and make tools available to help this vulnerable population.

7) Work with a PBM partner that has capabilities and connections to address the specialty drug challenges.

“With the rising use of specialty drugs, the days of 1% to 2% increases in annual drug spend are nearing an end,” said Peter Wickersham, Prime Therapeutics’ senior vice president of cost of care, in a press statement. “We are clearly entering a time of higher costs and plan sponsors who act now will be in the best position to assure quality care for their members while managing these high costs.”