Specialty Drug Cost Management
Prescription drug prices are consistently the single-biggest contributor to rising medical expenses. In particular, specialty drugs used to treat rare or complex, often chronic conditions can be extremely costly, accounting for almost 50% of payors' expenditures for prescription drugs. This can result in members experiencing financial hardship or non-compliance with treatment because they lack the means to get the care they need.
works with SmartPayRx to help curb spending on high-cost specialty prescription drugs. The program controls medical benefit and pharmacy spend through focused pre-authorization, site maximization, specialty pharmacy cost negotiation, voluntary co-pay assistance program fulfillment, and rebates.
The program offers the most effective High-Cost Drug Management Program by matching utilization oversight with strategies and targeted programs to deliver market leading discounts.
High-Cost Drug Management:
- Preventing wasteful specialty drug spending
- Utilizing management services ensure safe, clinically appropriate use of high-cost specialty drugs
- Managing the site of care for drug delivery Validate against prior authorization and clinical norms
- Securing deeper discounts