Prime releases autoimmune drug cost report
According to the report, only five out of every 1,000 members are in need of autoimmune drugs, but the cost of the drugs in that class are among the most expensive and are increasing faster than any other kind. Across the medical pharmacy benefit, autoimmune drugs equal one out of every $10 spent when it comes to prescription drugs.
During Prime’s four-year study of the cost of autoimmune drugs, it was discovered that prices increased by 38 percent and spending rose more than 100 percent.
The experts at Prime who conducted the research have suggested strategies for cost control that will help keep the focus on member health and outcomes.
These strategies include:
***Utilization management to ensure the right members are using the right drugs at the right time;
***Site of care optimization, encouraging members to use high-quality, cost-effective options;
***Exploration of indication-based formulary strategies;
***Formulary management to ensure the most clinically and cost-effective medicines are delivered at the lowest member cost share; and
***Specialty pharmacy services including accurate and timely prescription processing, personalized, condition-specific care management, benefit support, and care coordination.”