Industry estimates show that more than half of a health plans specialty costs fall on the medical side, yet plans traditionally have focused on managing only those drugs that fall on the pharmacy side. One tactic encouraged by PBMs is to shift specialty drugs from the medical side to the pharmacy benefit in order to easier manage them. But some payers are choosing to leave the drugs in the medical benefit and manage them there.

Managing Specialty Drugs Across the Medical and Pharmacy Benefits is a practical report filled with details of strategies health plans are employing to effectively manage specialty drugs under the medical benefit using pharmacy benefit principles. You'll read about the outcomes being seen and pitfalls to avoid at companies like Blue Cross Blue Shield of Florida, RegenceRx, CVS Caremark and Express Scripts.

For more information or to order your copy today, please call 888-446-3530 or visit:
http://store.hin.com/product.asp?itemid=4410

As plans consider a variety of strategies to control their skyrocketing specialty costs, Managing Specialty Drugs Across the Medical and Pharmacy Benefits will shed light on this approach that, if implemented correctly, can produce significant cost savings.

Table of Contents

  • Site-of-Care Optimization Can Reap Big Medical Benefit Savings
  • Ensuring Appropriate Drug Use and Site of Service Could Be Improved
  • Managing Specialty Pharmacy Medications Accessed Through the Medical Benefit: Challenges and Strategies
  • Integrating Pharmacy and Medical Benefits
  • Survey Shows Employers Need To Boost Specialty Knowledge
  • Plans Boost Specialty Management, but Improvement Is Still Needed
  • CVS Caremark Says It Will Manage Medical Benefit, Joins Other PBMs With Service
  • Express Scripts Survey Takes Closer Look at Medical Specialty Spend
  • PBMs Take Aim at Much-Needed Medical Benefit Drug Management
  • New Express Scripts Unit Includes Medical Benefit Management
  • Beyond Buy and Bill: Managing Specialty Therapies Under the Medical Benefit
  • Fourth Tiers Could Generate Drug Savings or Increase Medical Spend
  • Coverage of Oral, IV Oncology Drugs Can Hinder Compliance
  • Location of Benefits Coverage for Eight Specialty Medication Classes
  • Plans Look to Rein In Specialty Spend by Managing Medical Benefit

Order Managing Specialty Drugs Across the Medical and Pharmacy Benefits today and stay up-to-date with how organizations are managing specialty drugs under the medical benefit using pharmacy benefit principles.
http://store.hin.com/product.asp?itemid=4410

Please feel free to contact our customer service department with any questions you may have.

Warm Regards,

Melanie Matthews
Executive Vice President
The Healthcare Intelligence Network
800 State Highway 71
Suite 2
Sea Girt, NJ 08750
888-446-3530
http://www.hin.com


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