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Specialty Drug

Specialty Drug

8 min read

High-cost complex medications often requiring special storage or administration.

Outline

What is driving prescription drug costs higher for employers?
- Specialty drugs are expensive because small use can create large claims
- GLP-1 demand is adding a new layer of cost pressure
How smarter formularies can lower costs without hurting care
- Move generics and biosimilars into preferred positions
- Use lower copays to make better choices easier for employees
Why PBM contract transparency matters more than ever
- Direct PBM contracts can uncover hidden markups and rebate gaps
- The right reporting helps leaders track measurable outcomes
A practical plan for managing GLP-1s and other high-cost drugs
- Use utilization reviews to support appropriate GLP-1 use
- Build a pharmacy strategy that is reviewed all year, not once at renewal

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