Specialty medications are very costly for employers and patients alike. Used to treat chronic and severe illnesses, specialty drugs often need special handling or administration. While specialty drugs make up a small fraction of total prescriptions, they account for nearly half of all Rx spending.
Each month, we provide an Insight for our users. In August's Insight, shone a spotlight on specialty drugs which can cost ten times more compared to non-specialty medications.
In addition to the hefty price tag, specialty drugs can be challenging to administer, often given by injection or infusion to treat complex chronic conditions such as Crohn's disease, osteoporosis, rheumatoid arthritis, and multiple sclerosis.
Patients taking specialty drug medications may need ongoing clinical assessment to manage challenging side effects, adding additional expense to already costly treatments.
One way to manage specialty drug costs is by changing locations. For certain drugs, the price can vary significantly by the site of care where the drug is administered. According to the Business Group on Health 2022 Health Care Strategy and Plan Design Survey, 45% of employers use the site of care management to manage their specialty pharmacy expenses.
This common tactic has trailed closely behind prior authorization over the last three years. To ensure members use the preferred setting, employers can steer members using benefit plan incentives strategies.
Are you interested in diving deeper into specialty Rx savings? Get in touch with the Artemis team to explore more opportunities for recouping specialty drug spending.