Business, Drugs and Pharmaceuticals, Free News Articles, Insurance, Reports and Studies

Trends in Drug Benefit Design Report Released by Pharmaceutical Strategies Group (PSG)

DALLAS, Texas -- Pharmaceutical Strategies Group (PSG), an EPIC company, is pleased to announce the launch of its Trends in Drug Benefit Design Report. The report delivers innovative research on the latest trends in the traditional (non-specialty) drug benefit. Sponsored by Rx Savings Solutions, it outlines the complexities of designing and managing the drug benefit and the cost challenges faced by consumers and plan sponsors alike.

KEY HIGHLIGHTS OF THE FINDINGS INCLUDE:

* Plan sponsors are grappling with the potential cost of weight loss drugs.

With respondents divided on weight loss as a lifestyle or chronic condition, 43% cover FDA-approved weight loss medications, and 28% may do so in the next 1-2 years.

"Employers are concerned about affordability, as well as the long-term side effects resulting from chronic use," commented Michael Medel, PharmD, Senior Vice President and Practice Lead Plan Sponsors. "While there is recognition of the positive health benefits of weight loss, the data is lacking today to support any significant cost-offset of those benefits."

* Most plans use more than one type of trend and utilization management program, such as prior authorization and refill too soon limits, but these programs can present challenges.

Growing percentages of respondents cited cost and cumbersomeness as barriers to utilization management programs. Two-thirds of respondents wanted more transparency and accountability in these programs, and over half expressed interest in new offerings for tracking and controlling utilization.

* Major advancements have been made in gene and cell therapies over the past 5 years, and as the pace of change increases, interest in financial protection products is growing.

Nearly all (91%) respondents have heard of gene therapy financial protection products. While just 7% currently use these products, nearly half are considering it.

"With a robust cell and gene therapy pipeline, plan sponsors are seeking ways to mitigate the financial risk these expensive therapies present while also ensuring access for their members. Although few are currently using cell and gene therapy financial protection products, many are considering it. This will be an interesting trend to watch in the coming years," noted Morgan Lee, PhD, MPH, CPH, Senior Director, Research & Strategy, PSG.

* Plan sponsors recognize the need to reduce wasteful drug spend.

A little over half of plans (53%) take steps to identify and reduce wasteful spend in the formulary; that percent rising to 75% when isolating the data to health plans. Blocks, exclusions, and use of programs and reporting from their PBM are among the most common steps they take to address this problem.

* The monetary impact of cost-sharing strategies on consumers has spurred a focus on transparency.

The promotion of cost-sharing transparency tools to help members manage expenses continues to rise, from 28% in 2018 to 63% in 2023.

"We are honored to once again sponsor this insightful report, which highlights the importance for plan sponsors to evolve the pharmacy benefit," said Michael Rea, PharmD, Founder and CEO of Rx Savings Solutions (RxSS). "This year, there is a noticeable undercurrent of change in the market. Consumers and patients whose share of prescription drug costs continue to grow are searching for relief and turning to sources both within and outside of the traditional drug benefit. It's a goal all of us in the pharmacy benefit ecosystem to help advance the benefit in ways that produce greater access and affordability, all while controlling spend."

Since the inception of this report, the drug benefit has become more intricate to design and manage. With many new drugs coming to market, decisions around program structure, formulary design, cost sharing, and trend management become increasingly challenging and important. This report helps benefit leaders identify trends and future possibilities so they can adjust as appropriate around these factors and more.

Download the "Trends in Drug Benefit Design" Report: Trends in Rx Benefit Design | Rx Savings Solutions (rxss.com): https://rxss.com/benefit-design-report-2023/

About the 2023 Trends in Drug Benefit Design Report:

The Trends in Drug Benefit Design Report provides in-depth insights into traditional (non-specialty) drug benefit trends and strategies and focuses on drug benefit design for the 2023 benefit year among employers, union/Taft-Hartley, and health plan respondents. The survey sample informing this report included 180 benefits leaders. Issues specific to specialty drugs are included in a separate report - Trends in Specialty Drug Benefits. This report as well as prior annual reports conducted by PSG can be found at https://www.psgconsults.com/research.

About Pharmaceutical Strategies Group (PSG):

Pharmaceutical Strategies Group, an EPIC company, relentlessly advocates for clients as they navigate complex and ever-changing drug cost management challenges. PSG functions as a strategic partner through industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year. Learn more: https://www.psgconsults.com/

About Rx Savings Solutions - Report Sponsor:

Rx Savings Solutions ("RxSS"), part of McKesson Corporation, works on behalf of everyone who takes prescription drugs and the health plans and employers who cover them. Founded by a former retail pharmacist, RxSS helps members reduce out-of-pocket prescription costs and a health plan's pharmacy spend. The solution layers on top of an existing pharmacy benefit and analyzes individual claims to identify and present cost-saving alternatives to each member. Our member engagement platform notifies members proactively anytime they have prescription savings available. Visit https://rxss.com for more information.

Related link: https://www.psgconsults.com/

This news story was published by the Neotrope® News Network - all rights reserved. ID:NEO2022

Business, Drugs and Pharmaceuticals, Free News Articles, Reports and Studies

PSG Announces Release of Highly Anticipated ‘Trends in Specialty Drug Benefits Report’

DALLAS, Texas -- Pharmaceutical Strategies Group (PSG), an EPIC company, is pleased to announce the release of its annual Trends in Specialty Drug Benefits report. Delivering visibility into the complexity of the specialty drug landscape, it offers detailed intelligence through proprietary research.

Specialty drug costs have continued to push the boundaries in terms of complexity and affordability. The complicated landscape must consider many variables, such as multiple dispensing channels, dual payment methods, and site of care. This report takes a detailed look into what plan sponsors are facing as they make decisions relative to specialty drug benefit plan design.

Alternative funding continues to be a hot topic as plans explore strategies to help offset the high cost of specialty drugs.

"As plans continue to seek ways to offset specialty drug costs, the market is divided as to whether alternative funding is a positive option or a detriment," commented Michael Lonergan, RPh, PSG President. "Affordability of specialty drugs for plans and members is driving this interest, while there is a concern about sustainability in these models."

Integrated pharmacy and medical claims data for managing specialty drugs remains essential.

"Total cost of care is a key concern, and payers rely on reporting that details how well specialty drugs are performing through the insights of integrated data. However, the challenge is in tracking clinical efficacy," observed Morgan Lee, PhD, MPH, CPH, Senior Director, Research and Strategy.

Affordability of cell and gene therapies will likely be a significant payer challenge in coming years.

"As the cost of specialty drugs continues to increase, some health plans and fewer employers have explored the use of value-based contracting (VBC), a performance-based reimbursement agreement. Rare disease treatments that are being targeted by cell and gene therapies will drive future spending," noted Renee Rayburg, RPh, Vice President, Specialty at PSG. "VBCs represent an effort into finding strategies for keeping costly specialty drugs accessible and affordable."

KEY FINDINGS FROM THE REPORT INCLUDE:

* Gene Therapies: 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.

* Alternative Funding: 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.

* Value-based Contracting: 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.

* Specialty Rebates: 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%).

Additional topics covered in the report include increasing usage of new-to-market formulary blocks, interest in site of care programs, prior authorization tracking and reporting, and use of strategies related to biosimilars.

Download the Trends in Specialty Drug Benefits Report and register for the 5/10/23 webinar here: https://www.psgconsults.com/2023specialtybdr-webinar

About the Trends in Specialty Drug Benefits Report

PSG has been researching and reporting on drug benefit design for over 10 years. The report takes an in-depth look at trends and best practices in specialty drug benefit design through the lens of comprehensive questions and responses from over 180 employers, health plans, and labor unions.

About Pharmaceutical Strategies Group (PSG)

Pharmaceutical Strategies Group, an EPIC company, relentlessly advocates for clients as they navigate complex and ever-changing drug cost management challenges. PSG's innovative drug management solutions, including Artemetrx(R) - PSG's proprietary industry-leading software for integrated drug management, deliver actionable insights with exceptional financial and clinical value. PSG functions as a strategic partner through industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year. Learn more: https://www.psgconsults.com/

Related link: https://www.psgconsults.com/

This news story was published by the Neotrope® News Network - all rights reserved. ID:NEO2022

Business, Drugs and Pharmaceuticals, Free News Articles, Product Launches, Software

NEW PRODUCT LAUNCH: Pharmaceutical Strategies Group (PSG) Announces Artemetrx Extend – Revolutionary Drug Management Reporting Tool Offers Powerful User Insights

DALLAS, Texas -- Artemetrx®, the industry's most preeminent platform for integrated drug cost management, is now even more robust with the launch of its new module, Artemetrx Extend™. With greater insights and analytics, Artemetrx Extend is a custom reporting tool that provides unparalleled data access through its user-friendly platform.

"Artemetrx delivers swift and easy access to valuable drug management insights. With Artemetrx Extend, our clients will be able to further tap into the rich integrated dataset of the Artemetrx platform," said Libby Johnson, PSG Chief Data and Analytics Officer. "Artemetrx Extend continues our long legacy of client advocacy and innovation, as the industry's best keeps getting better."

Can your organization quickly get its data-driven questions answered? Most plans get bogged down waiting for custom analytics when Artemetrx can respond in seconds. The major capabilities now available within Artemetrx Extend, through powerful filtering and drill downs, include the ability to:

* Determine how many members have medical claims associated with a diagnosis for a specific group

* Analyze the specific diagnoses that a particular drug is prescribed to treat for a population based on claims history

* Model the financial impact of switching from one preferred medication to another

* View spend and trend statistics on all drugs (specialty/non-specialty, medical/pharmacy) or search based on National Drug Code, Healthcare Common Procedure Coding System, or drug name

There are two versions of Artemetrx Extend available: Base Access is available for all users, and Power User Access is optional, allowing for custom report and dashboard building and the ability to save and share reports.

Artemetrx is a proprietary industry-leading web-based software for integrated drug management developed by Pharmaceutical Strategies Group. Artemetrx Extend is the latest in a series of innovations on the Artemetrx platform.

Learn more about how Artemetrx Extend: https://link.psgconsults.com/Artemetrx.Extend

About Artemetrx®

Artemetrx is a proprietary SaaS platform developed by Pharmaceutical Strategies Group (PSG), an EPIC company. As one of the first technology solutions in the market to integrate pharmacy and medical claims data for specialty drug cost management, Artemetrx continues to provide market-leading specialty drug insights to payers. It delivers unparalleled intelligence and line-of-sight into serious challenges perpetuating out-of-control drug costs and compromised patient outcomes.

More information: https://www.psgconsults.com/discoverartemetrx

About Pharmaceutical Strategies Group (PSG)

Pharmaceutical Strategies Group, an EPIC company, relentlessly advocates for clients as they navigate complex and ever-changing drug cost management challenges. PSG's innovative drug management solutions, including Artemetrx®, deliver actionable insights with exceptional financial and clinical value. PSG functions as a strategic partner through industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year.

More information: https://www.psgconsults.com/

Related link: https://www.psgconsults.com/

This news story was published by the Neotrope® News Network - all rights reserved. ID:NEO2022