Specialty and High Cost Medications
High cost specialty drug approvals in the U.S accounted for 75% of all drug approvals by the FDA in 2021 and this trend will continue in 2022 and beyond. Of these, 20 cell and gene therapies are projected to be approved by 2025 and more than 500 gene and cell therapies are in the development pipeline. While some industry experts say these treatments could transform medicine by curing diseases, we know there is still no industry blueprint for supply and delivery, administration and evaluation, and paying for these complex, more personalized treatments.
We are clinicians and business advisors.... we are the right team to put to work for you our clinical expertise and knowledge across the specialty drug supply chain including gene and cell treatments so you don’t have to worry about how to handle these new complex and very expensive treatments.
Pharmacy Specialty Drug Strategies:
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Review current strategies for high-cost medications across pharmacy and medical benefit and determine alternative approaches and assistance for cost savings and clinical management programs.
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Assessment of a full specialty pharmacy program around the following areas:
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Waste management
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New to market specialty medication policies
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Access to needed medications
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Funding resource services
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Risk management services
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Clinical advocates/ navigators
Medical Specialty Drug Strategies:
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​Review current strategies for high-cost medications under the medical benefit (J codes) and determine alternative approaches and assistance for cost savings and clinical management programs.
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Assessment of a full medical specialty carve out program along with the following areas:
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Determine optimal site of care
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Access to needed medications
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Post service, prepayment claim reviews
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Funding resource services
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Risk management services
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Clinical Advocates/Navigators