Assessment of Specialty Generics Contract with PBM
| Industry | Health System |
| Problem | A health system made a change in their PBM contract to separate specialty products into brand and generics. The client reached out to PHSL to ensure this was a financially beneficial decision and to aid in planning for future negotiations. |
| PHSI Solution | PHSL reviewed specialty generic rates using prescription claims data, reimbursement rates, and acquisition cost trends to provide insights on the resulting change for the health plan. |
| Results | PHSL’s data analysis indicated specialty generics follow a trend similar to non-specialty generics. This validated that a separate contract rate for specialty generics was a favorable decision the client, based on their specific book of business, and gave them the guidance to shape future decisions. |
Poll Results
August 2023 Question of the Month
What steps do you take when learning about an electronic prescribing challenge?
Root cause analysis: 0%
Compendia review: 0%
Engage a partner: 0%
All of the above: 50%
None of the above: 50%
July 2023 Question of the Month
Does your organization have a strategy for Humira biosimilar launches?
Yes, well defined: 0%
We have a framework: 50%
Waiting for clarity: 0%
No: 0%
Unaware of need: 50%
June 2023 Question of the Month
How far in advance of NDA/BLA expected approval do (or should) manufacturers begin planning their compendia submission strategy?
During Phase II Trials: 0%
Initiation of Phase III Trials: 66%
6 months prior to approval: 33%
3 months prior to approval: 0%
At time of approval: 0%
After approval: 0%
No strategy: 0%
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