Specialty pharmacy is a hot button issue for purchasers today. The current and potential medical benefits are enormous, but the costs are exorbitant, the pricing mechanisms and distribution channels complex, and there is variation in how drugs are handled in benefits structures. This guide is meant to provide some clarity for purchasers on what strategies to consider.
How to use this tool:
This guide outlines a variety of tactics, including payment reforms that purchasers should consider when implementing or expanding a specialty pharmacy management strategy.
Included in this tool:
This How-To-Guide covers the following topics:
- Introduction to Specialty Pharmaceuticals
- Challenges in the Specialty Pharmaceutical Market
- Common Pricing Practices by Health Plans and Pharmacy Benefit Managers
- A Complicated Landscape for Purchasers
- Using Claims Experience to Assess the Opportunity
- Building a Strategy: Payment Reform Opportunities for Specialty Pharmacy
- Building a Strategy: Other Opportunities for Specialty Pharmacy
- Contracting with your Health Plan
- Monitoring the Progress and Impact of your Program