Supporting members with complex conditions.
When it comes to supporting employees with chronic and complex conditions such as hemophilia, HIV, MS and oncology, having the right specialty pharmacy program is critical. These life threatening and debilitating diseases take a heavy toll on the entire family and require frequent, ongoing clinical support.
*Specialty program outcomes based on UHC commercial membership 2007 to 2010. Network contract savings based on 2011 commercial FI membership. Utilization management savings based on a sample of 2011 commercial ASO membership who implemented these programs Notification, Strategic Benefit Coverage Exclusions, Step Therapy, and Supply Limits. Individual plan results may vary.
Although specialty medications account for only 1% of all prescriptions, they account for up to 36% of costs under the pharmacy benefit.
In spite of the high cost of specialty drugs, it is important to focus on the patient and the condition and not solely on drug management.
Our total care management approach can help members become more engaged, which can lead to increased adherence and better health decisions – which can result in better health and lower costs.
Managing specialty medications under both pharmacy and medical benefits helps contain the total cost of care while improving the quality of life for employees living with complex diseases.