As the price of specialty drugs continue to rise, employers are desperately seeking to rein in their health care costs.
According to a recent survey of 487 large employers by Towers Watson and the National Business Group on Health, 80 percent of firms said that design changes to health and pharmacy plans represents the most significant strategic priority over the next three years.
More than half of employers (53 percent) said they have imposed new restrictions on specialty drugs, such as requiring prior authorization for prescriptions or limiting use based on clinical evidence. By 2018, a full 85 percent of employers plan to have such restrictions in place.
Employers are also increasingly not covering certain compounds that are prescribed by doctors and designed by pharmacists to address specific patients. The process of developing a patient-specific medication of course adds cost to the treatment, and some of the compounds may not be FDA-approved. Employers are identifying both of those points as reasons to exclude “inappropriate compounds” from their plans.