Managing specialty conditions

Specialty drug costs are on a meteoric rise, now exceeding 55% of total drug spend.1 What’s more, 35% of total drug spend is driven by medical drug spend.2 Integrated solutions and strategies – across both medical and pharmacy benefits – help you successfully navigate the complicated and evolving specialty landscape.

Lowering drug costs with biosimilars

Make sure your employees have access to the best treatments. Biologic drugs are changing lives for the people who need them – but often at a very high cost. Horizon and Prime promote the use of evidence-based biosimilar drugs that may cost up to 35% less while delivering the same outcomes.3

Greater savings potential, ease and expanded pharmacy options

FlexAccess™ is a copay assistance solution using Prime’s channel-optimized model to give your employees the best available discount when they get their higher-cost medicines. Not only can your employees see copays as low as $0, they may also be able to get their medicines from a broader range of in-network pharmacies, including specialty and retail locations.

Less waste, more savings opportunities

Certain high-cost medications may cause adverse side effects. For these medications, Prime provides a split, or partial, fill prescription with a prorated copay to align with the number of pills dispensed. This gives your employee the opportunity to try a medication to determine the existence and severity of side effects before continuing therapy, potentially saving money and reducing waste.

1 IQVIA Institute for Human Data Science. (2022, April). The use of medicines in the U.S. 2022. https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/the-use-of-medicines-in-the-us-2022/iqvia-institute-the-use-of-medicines-in-the-us-2022.pdf
2 Pharmaceutical Strategies Group, LLC. (2022). 2022 Artemetrx® state of specialty spend and trend report. https://www.psgconsults.com/specialtyreport2022
3 Roy, Avik and The Apothecary. (2019, March 8). Biologic medicines: The biggest driver of rising drug prices. Forbes.https://www.forbes.com/sites/theapothecary/2019/03/08/biologic-medicines-the-biggest-driver-of-rising-drug-prices/?sh=37c36b0718b0

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey.