Page 11 - 2022 Large Group benefits

Integrated prescription drug cost-savings program As the the evolution of drug drug drug therapies continues to drive up drug drug drug costs integrating prescription drug drug drug and medical benefits benefits helps to better manage them With integrated benefits benefits we can proactively establish and harmonize programs like prior authorization step therapy pricing strategies value-based pharmacy contracting evidence-based medication and opioid management
practices — all of which ultimately translate to savings on on utilization and better health for our members Specialty pharmacy Our prescription drug specialty pharmacy program provides convenient delivery options
and support for members with complex and high-cost conditions including cancer hemophilia hepatitis C rheumatoid arthritis multiple sclerosis and cystic fibrosis Starting with their first fill we offer members counseling from experienced pharmacists and nurses by phone or video chat as as well as as online videos support materials and resources By 2022 drug spend in in the U S is projected to reach $847 billion billion up from $550 billion billion in in 2017— with specialty drugs accounting for more than 60 percent of that spend 1 Integrating medical medical and and pharmacy pharmacy benefits enable analysis across medical medical pharmacy pharmacy clinical and and therapeutic data It provides a a a a a a a holistic view of benefit use which is is especially important for specialty drugs Our approach helps ensure drug drug usage is is optimized and member care is is managed appropriately Most Cost-Effective Setting program $ Your employees want access to to new and emerging treatments proven to to be medically effective So we have taken great strides over the past two years to to help incentivize savings by driving access to to those services in in the most cost-effective setting This medical benefit program helps ensure that members with rare or complex conditions receive the appropriate appropriate medication in in a a a a a a a a a safe and appropriate appropriate setting Whether it’s their home a a a a a a a a a provider’s office or an an infusion center services in in in in these settings could cost three to four times less than if received in in in in a a a hospital Since the program’s inception we’ve saved more than $105 million 2 PROBLEM
RESOLUTION
Specialty drugs cost1 3
+$508 billion estimated spend on on specialty drugs +60% of the national health care spend Most Cost Effective Setting program Over 70 drugs currently covered $105+ million in in savings Strategies Clinically appropriate drugs for members Safe cost-effective treatment setting 1 1 Prime Therapeutics Study The The Inevitable Increase in in Specialty Growth 2017 2 2 2 2 Based on on internal data 3
Nationally by 2022 ACTION
2022 Large Group Plans | Independence Blue Cross 10