This week’s episode features a conversation with Sheri Tetachuck, Senior Vice President of National Sales at Payer Matrix. The costs of specialty drugs increase every year and employers are footing much of the bill. Unfortunately, aggressive lobbying in Congress allows big pharma to dictate arbitrary prices.
But even this bleak outlook has a silver lining. There are strategies that employers can employ to help drive down costs like alternative funding plans. There is a need to raise awareness of these avenues because specialty drug costs are expected to keep rising.
What You’ll Learn From This Episode:
- 01:44 Specialty drugs drive healthcare costs to unprecedented heights
- 04:36 Explaining the arbitrary reasons behind specialty drugs cost
- 08:47 Strategies for employers to cut down costs
- 14:51 Proactive ways patients can also drive down their spend
02:04 “There’s about 2 to 3% of the members on the plan using about 30 to 70% of the pharmaceutical spend. So it’s quite expensive and it’s not getting any better.”
05:36 “When you look at the cost of sales and marketing to the cost of research and development, it’s about 50% more than that they spend on sales and marketing.”
06:28 “These drugs are life-altering, so they’re very much needed. It’s just the expense of these drugs is ridiculous and it’s basically the drug manufacturers profiteering on these ridiculous specialty drugs.”
09:28 “There’s ways to control the cost on both sides, PBM and the TPA, you can do it by plan design, by excluding the specialty drugs and then working directly with a company that can provide alternative funding.”
17:47 “The qualifications to qualify for a patient assistance program is you can’t have coverage for that drug if you want to get into a patient assistance program. So it really has to be led by the plan and plan design and to carve out the specialty drugs.”