Elephant in the Room: Are Employers Ready to Address Specialty Drug Spending?

Elephant in the Room: Are Employers Ready to Address Specialty Drug Spending?

Specialty drug costs continue to vex most health plan sponsors. This article from NEJM Catalyst brings to light some of the key issues and opportunities for employers. It highlights the Cleveland Clinic’s recent effort to eliminate $8.5 million of annual waste associated with two commonly used cardiovascular drugs. Employers have got to like that result! (more…)

Managing Orphan Drugs in Your Health Plan

Managing Orphan Drugs in Your Health Plan

While the rapid evolution of modern medicine offers innovations in patient care, the resulting advancements are placing a fair amount of stress on our existing service delivery and payment models.

A prime example is orphan drugs — defined by the FDA as drugs and biologics for the safe and effective treatment, diagnosis or prevention of rare diseases/disorders that affect fewer than 200,000 people in the U.S., or that affect more than 200,000 persons but are not expected to recover the costs of developing and marketing a treatment drug. (more…)

An Epidemic of Unnecessary Treatment

An Epidemic of Unnecessary Treatment

We wanted to share an article from The Atlantic by David Epstein that deeply resonated with us. It is long, but we encourage you to take the time to read it, and share it with others you care about. The piece does a great job of encapsulating a number of our longtime concerns as healthcare consumers and consultants regarding unwarranted, and sometimes even harmful, treatments that are commonly provided to our plan members. (more…)

Mr. President: Please Write a New Prescription for the FDA

Mr. President: Please Write a New Prescription for the FDA

Dear Mr. President:

First of all, congratulations on your stunning victory. You’ve re-written the playbook on how to get elected president. Your campaign strategy and tactics will be studied by scholars and politicians alike for years to come.

What you are now reading is an “open letter.” It’s addressed to you, but also intended to have a wider readership. We know you’re dealing with a number of pressing matters right now, but we want to make sure that you are aware of an important issue impacting the health of our people, and our nation’s finances. (more…)