Most benefit managers recognize specialty drugs as the primary cost driver in their prescription drug benefit programs. However, when asked, they don’t know how much they are actually spending on specialty drugs within their medical benefit.
It really isn’t their fault, the TPAs and insurance companies aren’t very good at reporting it (which might cause you to question their ability to manage it). As such, little attention has been focused on the medical portion, even though it generally accounts for more than a third of plan spend on specialty drugs*.
How do your plan results compare? Let us know if you would like to better understand the specialty drug spend in your plan, and what you can do to manage it.
*From Chelko Consulting Group’s proprietary database of employer results.
“Keeping Score” is an ongoing series where we share findings from our work on employer-sponsored health plans, so you have the opportunity to compare how your plan is performing relative to others. We hope you find it beneficial. Because, after all, you can’t manage what you don’t measure.