Employers Challenged by Expensive and Time-Consuming Specialty Drugs, According to Benefits Quarterly Magazine
The 2016 survey, developed by
In 1990, there were 10 injectable specialty drugs on the market which grew to 300 by 2015, according to the
Specialty pharmacy drugs are high-cost, high-touch medication therapies for patients with complex disease states, such as cancer and multiple sclerosis, which can be life-changing. Typically, these drugs are dispensed by specialty pharmacies and include oral, injected and infused biological products.
“We realize how difficult it has been for employers to provide the breadth of benefits they want their employees to have, yet keep their premiums affordable,” said
Other results included:
- 77 percent said they were somewhat to very challenged in being able to understand the complete picture of de-identified specialty drug claims associated with the medical diagnosis.
- 80 percent of employers said they were somewhat to very challenged by the trend of infusion for specialty drugs moving from doctor’s offices to often costlier outpatient hospital sites.
- 69 percent said formulary management was somewhat to a very important tool in managing specialty drugs.
- 31 percent used programs with provider incentives to use treatment pathways.
“Employers were so varied in the type of plan programs they were using to help manage specialty drugs,” said Napolitano. “It was interesting to see the high percentage of employers who found getting accurate, consistent measurement of specialty drug expenditures under both benefits to be challenging. As a company offering integrated pharmacy and medical benefits, we know those concerns can be overcome.”
Fifty-six percent surveyed said they were going to seek additional education on specialty drugs. Insurers can assist employers in understanding and using techniques, such as integrated benefit specialty management, managing infusion site of care, and specialty drug pathways, among other strategies.
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