NASHVILLE, TN-The rising costs of oncology drugs are leadingself-insured employers in Arizona, Colorado, and Nevada tore-evaluate treatment coverage as a medical benefit. A recentWest Health Plan Analysis indicates that plans will beginmonitoring practices to identify unnecessary drug treatments.
|The West Health Plan Analysis points out that health insurers inthe west typically report oncology treatment coverage as a medicalbenefit rather than a pharmacy benefit. This is because lower costsensure that patients can complete their treatment courses.
|However, a report by HealthLeaders-InterStudy indicates thatoncology treatment costs will continue to rise. In response,insurers will start to more aggressively monitor treatmentpractices to identify unnecessary drug treatments that aren’tdirectly linked to member health improvement – though the insurerswon’t determine the best treatment practices.
|“The challenge for health insurers and pharmacy benefit managersis keeping prices low enough that members complete theirtreatment,” said Bill Melville, market analyst withHealthLeaders-InterStudy in a press release detailing thestudy.
|“Carriers have already begun to move to greater oncologymanagement. As oncology drugs prove themselves to be more effectivethan other treatments, there will be a greater shift for preferredoncology treatments, such as intravenous and injectable breastcancer drugs.”
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