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Medical Directors Cast Wary Eye On Cost of Biologics

MANAGED CARE June 2006. © MediMedia USA
News and Commentary

Medical Directors Cast Wary Eye On Cost of Biologics

MANAGED CARE June 2006. ©MediMedia USA

Medical directors are worried about biologics, expecting that the success of these state-of-the-art medications will be the top cause of increased costs in 2006, according to a study by the consulting company MedPanel. The survey of health plan medical directors, representing about 30 million lives, indicates that health plans are increasingly turning to PBMs to help get a handle on biologics. The survey was conducted in February.

"MedPanel conducted a parallel survey in late 2004," says Stephen Bubb, MedPanel's senior director of quantitative pharmacy services. "Analyzed together, these two surveys illustrate a trend to limit choice in the area of specialty pharmacy services.

"Given the exploding costs of specialty products and new technologies, MCOs are exercising tighter control over precertification of products and services. Last year 75 percent required precertification by the administering specialist. This year that number was 87 percent."

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