How Are You Managing The 50% of Specialty Drugs Billed Under The Medical Benefit?
PharMedQuest, an innovative provider of Medical and Pharmaceutical Management Services, recently commissioned a White Paper from Access Market Intelligence (AMI), an independent market research company, entitled:
Bend the Curve: A New Era for the Management of Specialty Pharmaceuticals (White Paper)
An Introduction to Today’s Specialty Marketplace
Biologic, biotechnology-based, rare disease, or high-cost pharmaceuticals
— collectively known as specialty drugs — can be covered under the
pharmacy benefit, the medical benefit, or both depending on the benefit
design plan sponsors require of the third-party administrator (including
the pharmacy benefit manager – PBM; administrative service organization
– ASO; or any administrator of a medical or pharmacy benefit).
On average, up to 50% of specialty drugs today are covered under the
With the exception of a few key therapy areas, traditional tools used
to manage specialty drugs under the medical benefit, such as prior
authorizations and medical benefit carve-outs (i.e., “white-bagging”),
have yielded limited value to plan sponsors.
This thought leadership analysis, with insights from recognized industry
experts, will provide an overview of the challenges, a summary of the
key issues plan sponsors must address and insights into best practices
through an innovative new approach, Medical Benefit Drug Management
You can download the AMI White Paper by entering your information below.