PSG announces the results of its extensive research on the latest trends in specialty drug benefits.
This proprietary research provides detailed intelligence to support employers, labor groups, and other plan sponsors in managing specialty drug benefits. It provides evidence-based analysis of drug formulary design and utilization as well as pricing trends for specialty drugs.
Key Findings
- While just 24% of respondents have had a gene therapy patient, 81% expect affordability of gene therapies to be a moderate or major challenge in the next 2-3 years.
- 14% of employers and 7% of health plans use alternative funding models, and 14% of employers and 33% of health plans are exploring their use. However, 68% of respondents viewed these models as not at all or slightly sustainable
- Only 12% of respondents report using value-based contracting for specialty drugs. The need for additional evidence, difficulty agreeing on and tracking outcomes, and lack of resources and buy-in were all cited as key barriers to adoption.
- Nearly all plans receive specialty drug rebates under the pharmacy benefit, but health plans are more likely than employers to receive rebates under the medical benefit (66% vs. 27%).
