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Specialty Drug Cost Management

Specialty Drug Cost Management

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.

H.H.C. Group 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.

Pharmacy Cost Management:
  • Prevents wasteful specialty drug spending
  • Utilizes management services ensure safe, clinically appropriate use of high-cost specialty drugs
  • Controls the site of care for drug delivery Validate against prior authorization and clinical norms
  • Secures deep discounts

Medical Cost Management:
  • Co-Pay Maximizer
  • Minimal plan changes required
  • Implementable any time in the plan year
  • No PBM involvement/approval required

Contact us today to learn more about how we can help.

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