HealthAugust 06, 2024

Bridging the value gap by aligning medical and drug benefits

As drug production rapidly becomes more complex, medical and drug benefit teams within payer organizations need to get aligned with the latest evidence.

New drug approvals from the US Food and Drug Administration (FDA) hit an all-time high in 2023 and specialty drugs now account for 54% of claims spending. Medications are becoming more complex and developing more rapidly, underscoring the need for regular health plan policy development and design.

In the midst of all this development, payer teams remain fragmented between medical and drug benefit teams. Many organizations were originally designed to support high-volume, low-cost drugs. Now, specialty drug considerations are challenging that design with low-volume, high-cost production, creating efficiency challenges. Additionally, some medications and therapies can be covered by either medical or drug teams – or both.

Our new whitepaper “Bridging the value gap: Aligning medical and drug benefits for health insurers” explores the current state of fragmentation within payer organizations and the opportunity for internal alignment through evidence-based information and standardized technology. In the whitepaper, you can learn:

  • The increasing development in specialty and traditional drugs.
  • Challenges facing payer teams, especially in determining medical and drug policy.
  • Opportunities for better efficiencies by leveraging evidence-based technology.

Download the whitepaper to learn about how aligning benefit teams can help your organization prepare for increasing drug complexities and improve internal efficiencies.

Download the whitepaper “Bridging the value gap: Aligning medical and drug benefits for health insurers” by filling out the form below.
Solutions
Medi-Span
Embedded drug data and clinical screening modules to support appropriate medication prescribing
Organizations use Medi-Span® drug data and clinical screening modules to support appropriate medication decisions, and to help reduce prescribing errors by optimizing alert systems.
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