Past Meetings

The Impact of Specialty Pharmacy on the Future Drug Costs

11/15/13  Back

The primary topic of our November 15 meeting of Health TechNet was the disproportionately high costs of specialty pharmacy and the resulting impact on future drug and healthcare costs overall.

Health care expenditures have been growing at about 3.9% annually since 2009, the lowest rate of increase in recent history. The cost increases for most segments of health care, including hospital, physician and clinical services, nursing homes, is 4.3% annually over this period, while the increase for prescription drug costs is 2.9%. Specialty drug costs, on the other hand, have been growing at 16-20% over the last four years and this trend is expected to continue for the foreseeable future. During this meeting we discussed:

1) The historical context of what drives pharmacy costs and trends, and strategies to manage these costs.

2) What are specialty drugs and why are they so expensive?

3) What can be done to manage these costs?

Our speakers on this topic (kindly arranged by Lloyd Brodsky) was Hungching Chan and Renee Rayburg of OptumInsight. Dr. Chan leads the Pharmacy Analytics & Strategy practice within OptumInsight Consulting. She has more than 15 years’ experience in the analysis of health care utilization and cost data, measurement of health care quality, and outcome evaluation of clinical programs. HungChing’s consulting work is focused on medical and pharmaceutical management strategies supported by data analysis and modeling. She has worked with many health plans and employer groups.

Ms. Rayburg is Director, Managed Care Pharmacy Consulting, part of the Pharmacy Analytics & Strategy Group of OPTUMInsight. Currently, she is focused on specialty pharmacy management strategies and solutions for both the medical and pharmacy benefits. She has over 25 years’ experience as a pharmacist in a variety of pharmacy practice settings including both provider and payer.

We also discussed recent developments relating to the Obamacare website and other issues relating to the implementation of the ACA.