National Employer Initiative on Specialty Pharmacy

Project Scope
MBGH’s work in examining the value-based purchasing activities of employers has identified that the utilization and management of specialty drugs is a major focus and challenge.  Specialty drugs are increasingly being produced for a rising number of conditions and it is estimated that more than 800 specialty pharmacy drugs are currently in the pipeline with costs expected to represent up to 40% of an employer's total medical spend by 2020.   

 


What is the National Employer Initiative

on Specialty Pharmacy?     

Although some research efforts have been conducted in the area of specialty pharmacy, most have not explored the following key elements this employer driven initiative seeks to target:

  • Enhancing employer awareness and understanding of specialty pharmaceuticals
  • Creating a web-based toolkit that serves as an educational resource for employers
  • Sharing optimal approaches for innovation in benefit plan design and vendor contracting
  • Supporting employer efforts in managing and communicating with their at-risk population
  • Providing educational outreach to key health care stakeholders to support collaboration and optimize patient outcomes


This initiative involves four Work Streams (Work Streams Overview) and is
supported by an Employer Advisory Council of large, national self-insured employers in Chicago. A national employer benchmarking survey was launched in 2011 to determine the employer perspective on medical and pharmacy costs, current benefit offerings and best practices (See 2011 National Employer Survey results and 2011 MBGH News Release). A follow-up benchmarking survey was launched in the Fall of 2012 and provided a more in-depth view of the larger employer's perspective of the specialty pharmacy environment. In fact, survey results indicated that almost 50% of respondents had an above average understanding of specialty pharmacy benefits, while 37% have an average understanding. View additional key findings and access full 2012 Results

View Poster Presentation for 2013 AVBCC Conference

Employer Toolkit on Specialty Pharmacy Benefits   (launched January 2013 - www.specialtyrxtoolkit.com)
This MBGH toolkit will provide employers with information, best practices, and resources in the following areas:
(1) Specialty Pharmacy 101: Assists employers in better understanding the basics and economics of Specialty Pharmacy and related benefits
(2)  Managing Specialty Benefits:  Supports employers in effectively contracting and partnering with their PBMs, Health Plans and Specialty Pharmacies
(3) Supporting At-Risk Populations:  Helps employers understand the importance of managing their at-risk populations and communicating specialty benefits to their covered population


For more information on this initiative, contact Cheryl Larson, Vice President