How alternative payment models can make drug spend more predictable
Plan sponsors are facing rising and volatile drug spend, largely driven by high cost specialty medications. While they often account for less than 2% of all claims, these drugs can represent more than 50% of total spend.
This challenge is likely to get worse.
As of May, the FDA has approved 15 novel drugs in 2022. And increasing numbers of high-cost therapies are expected to receive approval in the coming months, making drug mix and cost even more difficult to forecast.
To better navigate the current and future pharmaceutical ecosystem, pharmacy benefit managers (PBMs) need to create new financial models that increase transparency, are powered by modern technology, and provide a greater degree of predictability in drug spend for health plans.
In this white paper, we will examine different payment models that are currently available in healthcare—and the importance of continuing to create new and novel approaches.
Understand the current challenges health plans are facing due to soaring and volatile drug prices
Compare and contrast pricing models that are currently being leveraged in healthcare
Determine the benefits of adopting alternate pricing models
