Specialty drug per employee cost trend refers to the change in specialty drug spend per employee from 2017 to 2018 for each company in our database. While the average increase of 11% is right in line with benchmarks, the year-to-year price movement for each company is all over the board. Only 15% of the groups in our database had a trend rate between 10% and 15%.
On a macro basis, specialty drugs are one of the biggest drivers of health plan cost increases — even though they are consumed by only 1% of the population. These are clearly outlier claims that will benefit from special handling. Health plans cannot manage specialty drugs the same as their traditional drug spend. The stakes are too high — and the practical opportunities to avoid unnecessary waste are too great to ignore.
How does your plan compare? Do you know what drugs are affecting your specialty drug spend? Do you know the practical options to better manage them? Let us know if you would like to gain more insight into this number and how to measure and manage employee and plan cost effectively.
*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.