Tuesday, January 19, 2016

"Managing specialty utilization and offsetting specialty drug price inflation ...

... should be top priorities for health plans and plan sponsors in 2016. New strategies that health plans and plan sponsors are implementing in 2016 include: validating all rebates were paid for 2015 specialty claims, pursuing additional rebate opportunities, analyzing which specialty drugs can be removed from the formulary to maximize rebates, implementing AWP [average wholesale price] protection to offset drug inflation, sharing utilization data with medical vendors and evaluating carve-out specialty programs. [There will also be a] focus on creating an industrywide definition of a specialty drug."

— Brian Anderson, a consultant for Milliman, told AIS's Drug Benefit News.

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