Survey finds widespread employer ignorance about specialty pharmacy

One-quarter have "little or no" understanding of specialty

CHICAGO — A "vast majority" of employers don't know how much they're spending on specialty drugs through their medical or pharmacy plans, according to a new survey by the Midwest Business Group on Health.

The MBGH surveyed 120 employers from around the country that had between 500 and 25,000 employees, finding that 25% had "little or no" understanding of specialty pharmacy, while 53% had only a moderate understanding of it. Meanwhile, almost 30% didn't know how much their total specialty claim costs had increased in the past three to five years. The MBGH conducted the survey under guidance from the Institute for Integrated Healthcare principal Randy Vogenberg.

"In addition to the uncertainty and challenges that health reform and the economy are placing on employers, health plans and pharmacy benefit managers, the real driver of drug cost trend growth for employers lies in biologics and specialty pharmacy," MBGH VP Cheryl Larson said. "Our research confirms that there is a broad lack of awareness and specific knowledge about benefit design related to specialty pharmacy that illustrates key gaps that need to be addressed."

The survey also found that 42% of employers used PBMs to manage specialty benefits, with 22% using their health plan and 18% using a combination of both, and 13% used a specialty pharmacy provider. Meanwhile, 76% didn't offer employees an incentive to ensure proper compliance to medication and adherence to treatment for use of specialty drugs.

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