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Specialty Drug Cost Management

HHC Can Help With:

  • Pharmacy Cost Management
  • Medical Cost Management

Specialty Drug Cost Management. HHC Can Help.

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.

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HHC Can Get the Job Done.

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
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26+ Years of Expertise = HHC Solutions That Work


H.H.C. Group is uniquely well qualified to provide this service given its:
  • 26+ years of experience successfully negotiating settlements on medical bills on behalf of payers nationally;
  • Highly experienced, attorney, licensed health insurance adjustor negotiators;
  • Proprietary database and access to multiple published databases;
Specialty Drug Cost Management Solutions That Work

We'll get the job done for you!

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SPECIALTY DRUG COST MANAGEMENT RESOURCES

Risky Side of Self-Insurance
SPECIALTY DRUG - THE RISKY SIDE OF YOUR SELF-INSURANCE HEALTH PLAN

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.

Impact on Self-Insurance
SPECIALTY DRUGS' IMPACT ON YOUR SELF-INSURED PLAN

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.