'Data integration and vendor oversight ...

... will be the reigning themes for specialty drug management in 2016. We expect to see the wide deployment of integrated data engines to support a more coordinated specialty management strategy across the medical and pharmacy benefit channels. Meanwhile, a 'trust but verify' mentality will drive increased scrutiny of existing PBM and health plan management protocols. We expect to see a growing demand for audits that focus on specialty prior authorization and clinical program outcomes.... If the PBM is not demonstrating vigilance, our more progressive clients may begin to explore the carve-out of these clinical management protocols as a strategic option in the next 24 months."

— Josh Golden, practice leader, employer consulting at Pharmaceutical Strategies Group LLC, told AIS's Drug Benefit News.