How can we manage the rising cost of specialty medications?

Although only 1% of pharmacy claims for commercial plans are for specialty drugs, they often account for greater than 50% of all prescription benefits spending. It will take bold new thinking to manage this trend.

HOW WE HELP

THE CHALLENGE

Specialty medications are used to treat the most severe and complex conditions, such as cancer, multiple sclerosis, and hepatitis. These drugs are far and away the most expensive of all. In fact, by 2023, the median list price for oncology and orphan drugs could exceed $200,000 per member per year. For this reason, for every payer serving any population, managing spending on specialty drugs must be a top priority.

9 %

Plans realize up to 9% in cost savings using MedImpact Direct Specialty
$ 500 billion

Projected spending in US on specialty medications by 2023
> 50 %

Percentage of total spending on specialty for commercial plans

Specialty medications.

Specialty medications are improving lives, yet skyrocketing costs are challenging for plans to manage. By integrating advanced clinical services, data analytics, high-touch member engagement, and a tightly managed network of specialty pharmacies, we have enabled clients to reduce specialty spend by, in some cases, as much as 9%.

Specialty management.

As specialty drug spending increases, MedImpact is delivering innovative strategies to manage costs and help improve member health.

Specialty network.

We work with five preferred specialty pharmacies that meet the highest levels of clinical standards and member service.

Clinical outcomes.

We provide clinical expertise, national strategy, local customization, and personalized member engagement programs to help improve population health.

Analytics.

To improve outcomes, CMS Star Ratings, and drug and medical spend, MedImpact’s Quality Performance Monitoring Program (QPMP) delivers information about adherence and potential safety issues from the population to the member level.

ON A MISSION

Connected care.

Every year, we invest hundreds of millions of dollars in technology, people, and solutions to make healthcare benefits more connected, personal, and affordable.