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.
Pharmacy Cost Management:
Medical 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
- Co-Pay Maximizer
- Minimal plan changes required
- Implementable any time in the plan year
- No PBM involvement/approval required
today to learn more about how we can help.