WASHINGTON, DC--(Marketwired - Jan 30, 2017) - The National Business Group on Health, a non-profit association of 420 large U.S. employers, today released a policy issue brief intended to help stem the skyrocketing costs of specialty drugs. The 31-page report provides policy recommendations to create more sustainable and affordable pricing for specialty medications. The issue brief also outlines the challenges that large employers and their employees face in paying for expensive biologic medications, or specialty drugs, and examines initiatives employers are taking to control rising costs.
"With spending on specialty drugs skyrocketing, large employers, and employees who use these medications, are struggling to manage rising costs," said Brian Marcotte, President and CEO of the National Business Group on Health. "Most employers we surveyed now rank specialty pharmacy as the number one driver of rising costs, leading us to develop these policy recommendations which we believe if enacted will help create improved financial sustainability and affordability of these drugs for patients and their health plans."
The 31-page report, "Policy Recommendations to Promote Sustainable, Affordable Pricing for Specialty Pharmaceuticals," notes the number of drug approvals, spending and utilization for specialty medicines are projected to overtake traditional pharmaceuticals over the next several years. These trends add to the growing sense of urgency for large employers, who continue to struggle with how best to manage these expenditures, and for employees, who are paying more out-of-pocket for these medications. Insurers, governments, patients and others are also concerned about growing expenditures for specialty medications.
"High specialty pharmacy prices are also facing growing public and political pressure," said Steve Wojcik, vice president of public policy at the National Business Group on Health. "Combined with employers' concern over their ability to manage rising costs, we believe now is the time to review public policies that influence the pricing, prescribing and administration of specialty meds."
The Business Group's five policy recommendations are separated across two major areas: examining and making changes to Medicare and Medicaid rules that inhibit better value and lower prices for medications, and reexamining policies to promote robust biopharmaceutical competition. The Business Group's five specific recommendations are as follows. Additional details on each recommendation are provided in the issue brief:
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Remove uncertainties surrounding risk-based and value-oriented contracting and implement indication specific pricing and reference pricing in public programs.
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Change rules around Medicare Part D protected drug classes
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Eliminate perverse payment incentives to providers under Medicare Part B
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Encourage the uptake of biosimilars, medications that compete with brand
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Reform permissive patent and exclusivity protocols