As the specialty pharmacy market grows, cost becomes a bigger issue

Specialty pharmaceuticals – injectable drugs used to treat chronic and rare diseases such as multiple sclerosis, various forms of cancer, Alzheimer’s and more – currently make up a $40 billion market, and that market size is expected to increase to $75 billion by 2008. Additionally, the specialty-drug marketplace has seen a large amount of consolidation in recent years, with pharmacy-benefit management companies now owning many of the specialty drug manufacturers.

With the growing market and increased consolidation toward PBM ownership, employers providing prescription drug coverage are faced with new challenges in terms of managing costs and administration, according to Brian Bullock, president and CEO of The Burchfield Group, a pharmacy-benefit consulting firm that helps employers reduce the cost of providing prescription drug coverage for their employees. Bullock and his colleague Rob Shelley, vice president at The Burchfield Group, discuss specialty pharmaceuticals and related concerns for employers in today's episode of the Pharmacy Benefits Podcast.

"These biotech drugs are expensive, and cost is a major issue. But when used in the right situations, they're life-savers," Bullock said. "Employers need to keep an eye on a few critical issues related to specialty pharmacy: distribution of the drugs, administration and waste, compliance tracking, and patient education. Costs for specialty drugs can easily get out of control if employers don't have the necessary oversight."

Shelley explains that The Burchfield Group has recently seen certain biotech drugs creep into the top ten common prescriptions for many employers, and costs for these drugs are increasing at nearly 20 percent per year, far outpacing increases in the rest of the pharmaceutical industry.

"I've been approached by employers asking about how to increase co-pays on specialty drugs, but I'm not sure that's the best approach," Bullock said. "The drugs are expensive, yes, but it is critical to make sure the consumer can afford these drugs and will use them appropriately – otherwise they won't be effective for treating illness."

Bullock invites his podcast listeners to submit questions and comments, which he and Shelley will address directly and in future podcasts. Send an e-mail to bbullock@burchfieldgroup.com or call 651-389-5640 with questions or to learn more about managing specialty pharmaceuticals.