The increasing popularity of specialty drugs has brought new challenges to health plan management. However, MedBen has closely followed their growth, and works with clients to develop strategies that balance their medicinal advantages with realistic cost considerations.

Back in 1990 ‒ roughly the same time MedBen launched its third party administration services ‒ there were just 10 specialty drugs on the market. Today, there are around 300 available, with a projected 700 more in various stages of development. Since 2010, half of all FDA approvals are for specialty drugs.

But those numbers don't tell the real story. While specialty drugs make up only 1% of all prescriptions, in 2014 they comprised 32% of total drug spending. That same year, spending on specialty drugs rose over 30%, compared to 6% for traditional medications.

When determining whether to cover a specialty drug, self-funded groups must consider its benefits (i.e., the potential to replace more expensive and prolonged medical treatment) along with its drawbacks (high cost, no assurance of effectiveness). MedBen, working in conjunction with our pharmacy advisor, offers clients recommendations on coverage levels as well as alternative medications and therapeutic options.

By providing educated guidance on the costliest drugs, last year MedBen limited average client trend on per-member pharmacy spending to just 4.1%, compared to 12.2% nationally. Learn more about how we can do the same for your group by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

You can download a list of new specialty drugs, including the diseases treated and estimated costs, from the MedBen website.