SOURCE: Pharmacy Benefit Management Institute

Pharmacy Benefit Management Institute

March 04, 2015 08:05 ET

PBMI Survey Shows Specialty Drug Cost Concerns On the Rise Due to Heightened Awareness

PBMI Specialty Drug Benefit Report Released

PLANO, TX--(Marketwired - Mar 4, 2015) -  According to the Pharmacy Benefit Management Institute's (PBMI's) survey, about one-half of respondents rate management of specialty drug cost among their top two management goals. This year's report surveyed 366 employers covering an estimated 23.5 million enrollees, including active employees, retirees, and their dependents.

"Now more than ever, plan sponsors are looking for information and programs to help them manage specialty medications," said Dr. Sharon Frazee, PBMI's Vice President of Research and Education. "Specialty medications designed to improve the lives of patients gives hope to tens of thousands of Americans living with serious and life-threatening conditions. At the same time, plan sponsors struggle to manage costs and stay informed in a rapidly changing environment."

Key findings from the survey include:

  • Cost-related issues are identified as the most predominant problems plan sponsors face with managing specialty drugs.
  • In both the medical and pharmacy benefits, the percentage of respondents reporting specialty drug cost trend between 1% and 10% declined in 2014 when compared to 2013 specialty cost trend. Additionally, the percentage of plan sponsors reporting specialty trend exceeding 20% increased significantly. 
  • Awareness of the importance of managing specialty drug costs has increased, especially in the medical benefit.
    • Compared to last year, a dramatic decrease in the percentage of respondents unsure of cost-sharing arrangements under the medical benefit and 36% fewer respondents reports that their plan has no cost sharing under the medical benefit (7% compared to 11% last year).
  • Utilization management strategies continue to be under-utilized as a cost management tool, particularly in the medical benefit.
  • Plan sponsors are interested in learning more about specialty medication management with 69% of respondents this year indicating that they likely or definitely desire further education on specialty medication management.

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The mission of the Pharmacy Benefit Management Institute (PBMI) is to create the industry's premier forum for health care purchasers to exchange ideas, advance best practices and drive appropriate changes in the pharmacy benefit management marketplace.

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