Report: Gaps May Exist in Some Specialty Drug Management Strategies
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May 08, 2025
Although people who utilize specialty drugs represent only about 6% of commercially insured member populations, they contribute to more than half of the overall pharmaceutical spend. Payers are struggling to get this spend in control and may employ a variety of strategies in their efforts, including utilization management (UM) strategies, as well as newer tactics such as copay accumulators and maximizers. In a new report, Pharmaceutical Strategies Group (PSG), an EPIC company, pulls back the curtain on specialty drug management strategies.
For the 2025 Trends in Specialty Drug Benefits Report, which was published on April 28, a PSG survey collected responses from Sept. 16, 2024, through Oct. 15, 2024, from benefits leaders from employers (71% of total respondents), health plans (24%) and unions/Taft-Hartley plans (5%) with a median of 10,000 covered lives. The report was co-sponsored by Genentech USA, Inc., a member of the Roche Group.
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