IFEBP provides tips on managing specialty drugs

The retail price of specialty drugs increased by almost 10 percent in 2015, following nine years of increases, according a study from the AARP. In the report, No Magic Pill to Cure Specialty Drug Costs (But Some Preventive Measures), the International Foundation of Employee Benefit Plans (IFEBP) provided tips for employers to help manage the cost of specialty medications.

The IFEBP provided the following tips:

  • Change where specialty drugs are administered (called site of care). Having the patient go to a clinic or the doctor’s office increases costs. Could the drug be self-administered at home? Or, if someone must administer the drug to the patient, could it be done via a less costly home care service?
  • Review the pharmacy benefit manager (PBM) contract. Look for inconsistent definitions. Ensure the PBM passes all rebates on to the employer plan.
  • Refer participants to patient and copayment assistance programs to receive financial help.
  • Establish a prior authorization program, or review an already established program. Have a pharmacist develop/review the specified clinical criteria for coverage.
  • Encourage the use of lower cost alternatives.
  • Implement a care management program through which a care manager will work with participants taking specialty medications.

SOURCE: www.ifebp.org
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