Specialty drugs can improve quality of life, extend life expectancies and – in some cases – even cure disease. But with the monthly cost for a specialty drug therapy averaging $3,000, and the most expensive costing up to $2.1 million for a full course of therapy, insurance carriers and employers are struggling with the question of how to handle these astronomical costs.
With 300 specialty drugs currently on the market and with another 700 in the pipeline (according to Strategic Benefit Advisors), employers are under major pressure to craft a specialty drug strategy. But only about half of large employers (500 or more employees) have taken the fairly basic step of steering employees to fill their specialty medications in a specialty pharmacy, according to Mercer’s 2018 National Survey.
This article in Human Resource Executive, which quotes Mercer’s pharmacy practice leader David Dross, does a great job of both sizing the problem and outlining the various strategies employers are using to slow growth in specialty drug spend. If you’ve been feeling discouraged about the lack of good options, you should definitely check it out – it’s helpful to read how employers are finding savings opportunities right now and taking advantage of them. And even when the news is more bad than good, knowledge is power: Growing awareness of spiraling specialty drug cost is driving more employers to re-evaluate their need for stop-loss insurance to make sure they can handle that $2M claim – because it’s coming. Check out this blog post by Dan Davey, Mercer’s Stop Loss Specialty Practice Leader, to learn how the use of stop-loss is growing even among the largest employers.