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Variability of specialty drug prices requires improved oversight

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MINNEAPOLIS — With specialty drugs accounting for an ever-rising percentage of overall U.S. prescription drug spending, employers need to improve measurement and oversight of the medications provided to workers, speakers said Monday at World At Work's Total Rewards 2015 Conference and Exhibition in Minneapolis.

Corey Belken, vice president of business development for specialty drug analytics firm Artemetrx L.L.C., said one reason companies need to keep a close eye on specialty drugs is that prices for the same drug can vary widely between health care facilities.

For example, while acquisition cost of the chemotherapy drug Neulasta for medical facilities is between $3,500 and $4,000, the drug can be billed anywhere between $3,000 and $14,000 for patients, Mr. Belken noted. “What's concerning about specialty drugs is the variability in pricing that we see overall,” he said.

The need for companies to measure and manage this variability will become more acute as specialty medications to treat a range of maladies from high cholesterol to hepatitis C to cancer are approved by the U.S. Food and Drug Administration and become available in the next few years.

“We continue to see more and more drugs in the pipeline, and about 40% of the specialty drugs now in the pipeline are oncology drugs,” Mr. Belken said. “The FDA over the last two or three years has really gotten its act together and is approving these medications at a much higher rate than it was just five or 10 years ago.”

Shannon Ambrose, vice president of product development and management with Artemetrx, said that given the rising use of specialty drugs, companies need to understand how their spending on specialty drugs compares with a variety of metrics such as overall prescription drug spending.

“You have to talk with your health plan and pharmacy benefit manager to understand what your specific your trend is,” Ms. Ambrose said.