Specialty Pharmacy Trends and Strategies: 2016-2017 Edition

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Publication Details

  • Pub Code: GSPRX9-11WEB
  • Pages: 344
  • ISBN: 978-1-939721-17-4
  • Copyright 2016

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Specialty Pharmacy Trends and Strategies: 2016-2017 Edition

Covers the most relevant topics in the specialty pharmacy arena, with details on the latest trends in: hepatitis C management; management of PCSK9 inhibitors; cost-control tactics such as formulary exclusions and placement; oncology management; biosimilars; specialty benefit design for commercial health plans; value-based specialty pharmacy initiatives; personalized medicine; the specialty pharmacy pipeline and other new products; and more. Includes a directory of SPPs and related services.

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Strategies to Improve Patient Outcomes and Control Soaring Specialty Rx Costs

As hot-button issues continue to arise in the specialty pharmacy marketplace, look to Specialty Pharmacy Trends and Strategies: 2016-2017 Edition to quickly get up-to-speed on the most relevant topics. This convenient resource details the latest management strategies and tactics for:

  • Cost-control measures. Formulary exclusions, benefit design strategies and managing specialty drugs via the medical benefit.
  • Hepatitis C drugs and PCSK9 inhibitors. Managing the ultra-high costs of hep C treatments Sovaldi, Harvoni and Viekira Pak, and the PCSK9s Praluent and Repatha.
  • Biosimilars. The impact the launch of Zarxio — and controversies surrounding it — has had on the market, products in the pipeline and the debate over federal oversight.
  • The 340B federal discounted drug pricing program. Reimbursement and distribution issues, as well as questions that linger despite recently proposed guidance.
  • Personalized medicine. Payer coverage and FDA monitoring of genetic tests.
  • Oncology management. Value-based models such as bundled payments, clinical pathways and oncology medical homes, as well as treatment strategies for managing specific cancer types.

Specialty Pharmacy Trends and Strategies makes it easy for you to stay on top of the business side of the industry with:

  • Details of merger and acquisition activity, plus contracting, partnerships and alliances.
  • Summaries of organizational and leadership changes.
  • Exclusive data on average deductibles, out-of-pocket costs and cost share from AIS’s comprehensive database of prescription benefit parameters of individual and small-group commercial health plans.
  • Round-ups of trend studies, spend reports and spend projections — including costs for public exchange enrollees.
  • Price information on all specialty drugs approved or expanded by the FDA in 2015.
  • Recaps of developments in the pipeline and insights into new product launches.
  • Updated directory listings of SPPs, home infusion providers, PBMs and pharmacy benefit management vendors.

A convenient CD version of Specialty Pharmacy Trends and Strategies is also available. The portable CD contains all of the information in the print version and you’ll find what you need instantly with the user-friendly, searchable PDF format. Plus, all CD purchasers receive a free copy of the print version!

Get a handle on the issues, alliances and tested cost-saving management strategies in the specialty pharmacy marketplace — and stay competitive — with Specialty Pharmacy Trends and Strategies. Order yours today!

Table of Contents

Chapter 1: Timeline and Evolution of the Specialty Pharmacy Industry

  • Mergers and Acquisitions
    • 2014 Mergers and Acquisitions
    • 2015 Mergers and Acquisitions
  • Specialty Pharmacy Evolutionary Timeline
  • Financial Developments and Results
  • Alliances, Partnerships and Contracts
  • Product Launches
  • Organizational and Leadership Changes at SPPs

Chapter 2: Management of Hepatitis C

  • Ultra-High-Cost Products (Sovaldi, Harvoni, Viekira Pak)
  • Treatment Options and Strategies
  • Formulary Strategies for Hepatitis C Drugs
  • Exclusive Outcomes-Based Contracts
  • Legal Scrutiny of Hepatitis C Drug Data

Chapter 3: Oncology Management

  • Treatment Options and Strategies
  • Table of Oral Oncology Products
  • Strategies for Managing Specific Kinds of Cancer
  • Oncology Drug Spend
  • Reimbursement Legal Challenges
  • Value-Based Oncology Initiatives
    • Bundled Payment Strategies
    • Clinical Pathways
    • Oncology Medical Homes

Chapter 4: PCSK9 Inhibitors

  • Launch of Praluent and Repatha
  • Cost Challenges
  • Treatment Efficacy
  • Payer Strategies for PCSK9s

Chapter 5: Multiple Sclerosis Management

  • Therapeutic Options
    • Launch of Glatopa
  • Pricing and Costs for MS Drugs

Chapter 6: Biosimilars

  • Zarxio Approval and Launch
    • Amgen/Sandoz Lawsuit
  • Biosimilar Pipeline
  • Federal and State Guidance and Oversight

Chapter 7: Specialty Benefit Formulary Tier Design and Coverage Decisions
Featuring exclusive original research from AIS’s comprehensive database of prescription benefit parameters of individual and small-group commercial health plans!

  • Cost-Sharing and Formulary Treatments of Specialty Drug Products
  • Specialty Formulary Tier Limitations and Exceptions
  • Prevalence of Coverage Under the Specialty Formulary Tier
  • Statistics on Average Out-of-Pocket Costs for Specialty Drugs
  • Specialty Tier Cost-Sharing Requirements per Insurer
  • Trends in Specialty Pharmacy Cost Sharing and Benefit Design

Chapter 8: Payer Strategies for Controlling Costs

  • Pharmacy vs. Medical Benefit
  • Copay Coupons
  • Benefit Design Strategies
  • Formulary Placement and Exclusions
    • Placement of HIV/AIDS Drugs

Chapter 9: Value-Based Initiatives

  • Payers’ Quality Initiatives
  • Pharmacy Networks
  • CMS Value-Based Programs
  • Value-Based Pricing

Chapter 10: Medical Management of Specialty Drugs and Drug Products

  • Site-of-Care Strategies
  • Supply Concerns
  • Handling of Specialty Drugs
  • Orphan Drugs
  • Management of Adverse Events

Chapter 11: Personalized Medicine

  • Payer Coverage of Genetic Tests
  • Appropriate Use of Genetic Tests
  • FDA Monitoring of Laboratory Developed Tests and Diagnostic Tests

Chapter 12: Specialty Drug Trend and Spend Reports and Projections

  • Drug Trend Studies
    • Costs for Exchange Members
  • Pricing for Specialty Drugs

Chapter 13: FDA Approvals of Specialty Drugs and Diagnostic Tests

Chapter 14: 340B Federal Drug Program

  • Federal Oversight of Program
  • Industry Response

Chapter 15: Specialty Pharmacy Services Directory

Written By

Specialty Pharmacy Trends and Strategies is written by the staff of Atlantic Information Services, Inc.

Written For

  • Specialty pharmacies
  • Managed care payers
  • Disease management companies
  • Pharmaceutical retailers
  • Physicians
  • Pharmaceutical and biotech developers and manufacturers
  • Pharmacy benefit managers
  • Pharmaceutical distributors
  • Home health providers
  • Specialty outpatient clinics

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Specialty Pharmacy Trends and Strategies: 2016-2017 Edition

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