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.
LEARN MOREThe 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:Sixty-three percent of companies in the U.S. self-fund employee health benefits. Undoubtedly, these enterprises have carefully contemplated the risks associated with a high-cost, adverse health event. In addition, the risk managers at these companies have probably spent more than their share of sleepless nights fretting about a "bad luck" year with out-of-the-ordinary aggregate claims.
To put it simply, a specialty drug is any medication used to treat chronic, rare, or complex conditions like hepatitis C, multiple sclerosis, or certain types of cancers. They are novel drugs that typically don't have generic, low-cost, counterparts. These medications can provide remarkable therapeutic effects, but the costs can be steep.