Few employers have a thorough understanding of specialty pharmacy benefits, and only a fraction are of them are aggressively managing what is becoming one of the fastest-growing areas of health care spending, a new survey shows.
A national survey released Sept. 29 by the nonprofit Midwest Business Group on Health in Chicago, one of the nation's largest business coalitions, found that 25% of employers have little or no understanding of specialty pharmacy and 53% have only a moderate understanding.
Moreover, 70% of the 120 employers who said their specialty pharmacy was managed by their health plan said they did not know how much their company was spending on those drugs, while 30% indicated that they did not know how much their total specialty pharmacy claim costs had increased during the past three to five years.
Identify and assess
“In addition to the uncertainty and challenges that health reform and the economy are placing on employers, health plans and pharmacy benefit managers, the real driver of drug cost trend growth for employers lies in biologics and specialty pharmacy,” said Cheryl Larson, MBGH vp, in a statement. “Our research confirms there is a broad lack of awareness and specific knowledge about benefit design related to specialty pharmacy that illustrates key gaps that need to be addressed.”
The objectives of the survey were to identify and assess the level of knowledge and benefit design gaps of employer plan sponsors in the area of specialty medications and biologic products used to treat conditions such as multiple sclerosis and arthritis. These drugs often require special approvals for their use, instructions on dosing and side effects, and appropriate storage and distribution.
The proportion of employers' pharmacy benefit expenditures attributable to specialty drugs grew by 17.4% in 2010, the fastest pace since 2004, according to Medco Health Solutions Inc.'s 2011 Drug Trend Report, which found that specialty drugs represented 16.3% of total health benefit costs. ~businessinsurance.com~