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Specialty Pharmacy

For the first time in 2010, the number of specialty drugs approved by the FDA surpassed that of traditional drugs, kick-starting a trend that we're continuing to see year after year. While only a small fraction (approx. 4%) of the patient population uses specialty medications, these costly drugs now account for 25% of total US drug spending and is the fastest growing cost in most employers' health benefits. Employers are facing annual trend increases ranging from 18% to 30% due to generic and brand drug inflation and, most notably, to new breakthrough specialty medications. It is predicted that specialty pharmacy spend will outpace that of traditional pharmacy by 2018. What's more, there is substantial price variation among these drugs based on where the patient receives the medication.

At this stage, specialty pharmaceuticals most commonly address complex conditions such as cancer, respiratory illness, central nervous system disorders and inflammatory conditions such as rheumatoid arthritis and psoriasis. However, this catalog is expected to expand and diversify immensely in the coming years.

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Featured Resources

Large Employers' 2019 Health Care Strategy and Plan Design SurveyLarge Employers' 2019 Health Care Strategy and Plan Design Survey
This year, the survey was redesigned to provide insight into large employers' views on the rapidly changing health care environment. This new information accompanies tried- and- true elements of the survey: critical benchmarking information on health care costs, plan design trends and employer initiatives.

Biosimilars: A Checklist Biosimilars: A Checklist
Checklist with tips on how to achieve savings through biosimilar utilization.

Specialty Pharmacy Management Series Toolkit Specialty Pharmacy Management Series Toolkit
Series of summary documents that explore a range of issues and key topics in the specialty pharmacy space.

 

 

Also of Interest

Blog Post: How can Employers Contain the Skyrocketing Cost of Specialty Pharmacy Drugs?
Specialty pharmacy is identified as the second top cost driver for 2016 after high-cost claimants. Employers can influence their specialty pharmacy trend through effective tactics at different touchpoints.

National Committee on Pharmacy Benefits and Specialty Medicine
The Committee focuses on identifying ways employers can optimize different strategies for specialty medication management.

Pharmacy/Prescription Drugs Resources
Access all Pharmacy/Prescription Drugs resources in the Public Policy section.

 

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