Specialty Management Program

In recent years, the pharmaceutical industry has seen a sharp increase in the number of specialty drugs receiving FDA approval, a trend that shows no signs of slowing down. This is largely driven by advancements in research and technology, which have enabled the development of treatments for complex and rare conditions that previously had no solutions. Today, more than half of newly approved drugs fall into the specialty category, and with this growth, specialty drug costs are expected to keep rising. Moreover, experts predict that specialty medications will account for nearly two-thirds of new drug launches over the next five years.

Specialty drugs, while used by only 5% of the population, significantly drive overall drug spending. In 2021, specialty drug costs totaled $301 billion, reflecting a 43% increase since 2016. These medications accounted for 50% of total drug spending, demonstrating their substantial financial impact to the healtchare system. Addtionally, healthcare providers are  becoming more comfortable prescribing these drugs, and patients are more open to trying various treatment forms, such as injectables, which can provide additional benefits.

At MindfulRx, we are fully aware of the financial burden posed by the increasing cost of specialty medications. Our Specialty Management Program is designed to address these challenges with tailored strategies that meet the specific needs of health plans, providers, and other healthcare organizations.

Our program focuses on high-cost drugs by identifying clinically comparable alternatives that are both effective and more affordable. We leverage evidence-based data to ensure that any recommended alternatives meet safety and efficacy standards. By working closely with healthcare providers, we make sure that cost-saving alternatives do not compromise patient outcomes.

In addition, we tailor our initiatives to each plan’s formulary and provide robust patient support. We can focus on specific therapeutic areas by promoting the adoption of biosimilars and alternative medications for conditions that significantly impact our customer's healthcare-related expenses. We also work to maximize opportunities for alternative funding, such as copay assistance programs and foundations, ensuring that high-cost medications remain accessible. Our approach balances cost-effectiveness with clinical integrity, helping you reduce expenses while maintaining the highest standard of care.

References:

  1. Office of the Assistant Secretary for Planning and Evaluation.  Trends in Prescription Drug Spending, 2016-2021. September 2022: https://aspe.hhs.gov/sites/default/files/documents/88c547c976e915fc31fe2c6903ac0bc9/sdp-trends-prescription-drug-spending.pdf

  1. National Association of Specialty Pharmacy: Specialty Pharmacy Outlook 2024: https://rxinsider.com/market-buzz/?p=17144-specialty-pharmacy-outlook-2024

  2. Source Artemetrx report: https://www.managedhealthcareexecutive.com/view/spending-on-specialty-drugs-maintains-double-digit-growth