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Two of the key problems facing the specialty drug industry today are: Utilization Management; applying new tools for increasing control over appropriate use, and Drug Selection, also known as Formulary Management; shifting utilization to therapeutic equivalent and more cost effective alternatives. Over 47% of specialty drug utilization is managed by payors under the medical benefit. […]

Specialty drug trend continues to grow at 14-25% annually and it has become the number one drug management priority for payers. Specialty trend is driven primarily by Price, Drug Mix and Utilization and the imminent availability of the ICD-10 data standard creates new opportunities for utilization management programs that can reduce trend up to 7%. […]