March 14, 2023 by EVHC Editorial Team

Stop Getting Stung by High-priced Specialty Prescriptions

Do you know how stingrays protect themselves? They whip their tails at perceived threats. Their tails contain sharp spines filled with venom that pierce the skin of their foe. And since the tails are hidden from sight, the victim often doesn’t know what’s about to hit them until it’s too late.

You know, kind of like what happens when a person gets hit with their bill for a specialty or name-brand prescription. There’s a sudden shock, followed by the realization that there’s nothing they can do except pay up.

While specialty drugs comprised less than 1% of prescription sales in 2019, they accounted for 40% of total drug costs. That trend is projected to increase from 3% to 6% annually.

Feel the sting yet?

When’s a benefit not a benefit anymore?

If you’re like most business executives, you’re not only feeling it, you’re trying to figure out how to extricate those stingray barbs. Every year, you’re probably asking your broker how to manage skyrocketing prescription costs, looking for the lowest-priced plans while offering your employees access to the prescriptions they need.

The problem is that traditional cost control measures haven’t worked to reign in the amount of money spent on specialty prescriptions. Drugs like Humira, Eliquis, and other high-grossing prescription medications typically pull in tens of billions of dollars annually. Why? Consider the average cost of Humira prescription is $6,240 – and that’s with a coupon!

To compensate for the high prices, you’re probably passing a big part of the increased costs back to your employees to cover the difference. That means higher deductibles and copays. It also means a higher level of dissatisfaction among your employees. Suddenly, your exceptional health insurance benefits aren’t benefits anymore—not the message you want to put forward when attracting and retaining talent is critical to your organization.

Removing the stinger

The good news is that you have the option to help you take the sting out of the high cost of specialty drugs. Telemedicine—the process of shipping prescriptions from outside the country directly to a person’s home—paired with self-funded insurance can help your organization and employees get the prescriptions they require while still saving a ton of money.

Specialty medications are, overall, much cheaper in other countries as compared to the U.S. That’s because those countries have the authority to regulate prices and negotiate with drug manufacturers—unlike the U.S. Thus, prescriptions procured by other countries tend to be significantly cheaper than what they would cost stateside, sometimes by up to 40%.

Plus, having prescriptions delivered to one’s door is far more convenient than having to make a trip to the pharmacy or go to a hospital for special treatment. Sometimes that makes a world of difference. For example, we worked with one of our customers to create a customized diabetes management program that allows diabetic employees to receive direct delivery of supplies straight to their houses. With our program, the company has saved $1.4 million while providing great insurance benefits to its workers.

40% cost savings? Sign me up!

How does this process work? More importantly, how can it work for your company?

In our next webinar, I’ll be joined by representatives from our partner PriceMD to answer both of those questions and more. PriceMD provides self-insured health plan subscribers with the same specialty medications they would buy in the U.S. but for 40% less cost. PriceMD vigorously sources these medications, insures, protects, and delivers them directly to employees.

That webinar is, appropriately enough, called What Do Stingrays and Syringes Have in Common? I’ve already kind of answered that question, but not completely. To get the rest of the answer, you’ll have to join us on March 23, 2023, at 1:00 PM ET.

Register Now!

Alan Wiederhold is executive vice president at EVHC. Alan oversees EVHC’s strategy for providing brokers and clients with cost-effective health insurance options that save money without sacrificing care. In addition, he is an author, national speaker, and self-proclaimed healthcare nerd focused on creating new strategies for employers.