Compliance issues should guideyour decision on whether a drug or drug class or even all specialtydrugs should be excluded from your plan.

The cost of pharmaceuticals is forcing employers into abalancing act that's increasingly hard to maintain these days,making them straddle the line between compassion and their fiscaland legal responsibilities as high-cost drug claims continue tomount.

The pressure on drug costs has only intensified in recent yearswith specialty drugs that save or extend lives but carrybreathtakingly high price tags. Think Zolgenzma, which treats children with deadlyspinal muscular atrophy–at a cool $2.125 million. These drugs addto the burden of overall prices that are expected to rise6.3 percent annually over the next decade. Even before thespecialty drug phenomena, prescription costs have taken up afast-growing and outsized portion of total premiums, reaching16.5 percent by 2016 from 12.8 percent in 2012.

Continue Reading for Free

Register and gain access to:

  • Breaking benefits news and analysis, on-site and via our newsletters and custom alerts
  • Educational webcasts, white papers, and ebooks from industry thought leaders
  • Critical converage of the property casualty insurance and financial advisory markets on our other ALM sites, PropertyCasualty360 and ThinkAdvisor

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.