CHICAGO — Specialty drug costs are expected to account for 67% of prescription benefit spending by 2015, and employers should monitor how such drugs are being prescribed to their employees, panelists said Monday during a session at the Society for Human Resource Management conference in Chicago.

Gregory Madsen and Michael Staab, co-CEOs of Innovative Rx Strategies L.L.C. in Deerfield, Ill., spoke about innovative strategies in managing specialty drugs.

They defined specialty prescriptions as those that cost more than $600 for a 30-day supply, which often includes drugs used for conditions such as rheumatoid arthritis, multiple sclerosis and cancer treatment.

In offering tips to manage prescription benefit costs for such medications, Messrs. Madsen and Staab said employers should establish tiered co-payment plans that require employees to pay $75 to $100 for certain “preferred” specialty medications.

“If you have a $2,000 drug, $75 is still pretty high,” Mr. Madsen said of the cost to employees. “But it at least helps cover some of the cost share versus it being $25 like your typical brand co-pay.”

Another co-pay tier could require employees to pay 50% of the cost for nonpreferred specialty prescriptions that have significant costs, helping to push employees to lower-cost preferred specialty medications, Mr. Madsen said.

Employers should work with specialty pharmacies to distribute specialty medications rather than working with general retail pharmacies for such drugs, Mr. Staab said. Such providers often have pharmacists who can talk to patients about their prescriptions and provide guidance if they have stopped taking their medication or are coping with side effects.

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Employees should only receive 15 days worth of a specialty prescription when they first receive the medication, Mr. Madsen said. That’s because 18% to 20% of patients do not refill their specialty prescriptions after the initial prescription.

By reducing the initial amount, companies can help limit their prescription spending to those employees who plan to keep taking such medications, Mr. Madsen said.

“If you structure your benefit right … you can lower your initial cost of these things by about 7% to 10%,” Mr. Madsen said.

Subsequent prescription refills should last no more than 30 days, and employers should ensure that their specialty pharmacy won’t “auto-refill” the prescription each month, Mr. Staab said. This can help lower unnecessary spending on prescription refills that won’t be used, he said.