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MedBen University: Zaenger Spotlights Specialty Drug Problem

10/03/12

  06:29:29 pm, by MedBen5   , 199 words,  
Categories: News, Prescription, Health Plan Management

MedBen University: Zaenger Spotlights Specialty Drug Problem

Allan Zaenger, President of Pharmaceutical Horizons

Allan Zaenger, President of Pharmaceutical Horizons, discussed “The Specialty Drug Dilemma” at a recent MedBen University.

As Zaenger explained, even though generic dispensing has helped to keep price increases in check, the combination of high-priced specialty drugs, niche disease marketing and manufacturing incentives designed to circumvent traditional cost controls in prescription drug plans make it more difficult to control costs.

Zaenger emphasized that employers should encourage their prescription plan members to play an active role in buying drugs responsibly. In self-funding prescription benefits, plan sponsors have the advantage of controlling what the member pays through set copayments and deductibles.

One strategy Zaenger suggested is to require members to pay the difference whenever a generic alternative to a brand medicine is available and a brand is dispensed – even if there is a “dispense as written” or “DAW” required by the physician or member.

Zaenger also noted the popularity of manufacturer copay discount cards for brand-name drugs that have generic alterntives available. To control this issue, he recommended that plan sponsors adopt a 4th Tier member copayment equal to 100% of the allowed total claim charge – the full cost of the claim.

For additional information about MedBen University, visit MedBen.com.

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