Managing cost and quality for one of the industry’s foremost challenges
Specialty pharmacy is the fastest growing segment of drug spending. It accounts for nearly 40% of all drug costs each year. Additionally, over 50% of specialty drug spending is driven by drugs provided as part of the medical benefit, which are not covered by the programs in place to manage pharmacy benefit drugs.
Our Specialty Drugs Solution helps ensure consistent use of effective medications based on health plan medical policy. More than 200 drugs under medical benefit are reviewed against medical policy with dosing recommendations as appropriate. Our Solution entails:
- Clinical appropriateness review
- Physician and member drug guidance
- Guidance on preferred specialty pharmacies