(W3) Meeting the Evolving Needs of Self-Insured Employers in High-Cost Specialty Pharmacy

When it comes to providing health benefits for their workers, surveys show that self-insured employers view the cost of specialty drugs as one of their top business threats. Beyond drug costs, employers must address numerous other challenges that specialty medicines present to be able to offer affordable care to their employees. These challenges include wasted spend resulting from poor patient adherence or early discontinuation due to side effects, inadequate consumer education, delivery in more expensive sites of care, and rare but budget-busting events. Join this session as faculty highlight what is top of mind for self-insured employers, one of the largest and most important payer types in the U.S. health care system.

This session will cover how health plans can be more attractive to self-ensured employers by offering optimized benefit manager contracts based on employers’ unique needs or alternative payment models (e.g., value-based agreements or warranties) aimed at high-cost and clinically uncertain agents such as gene therapies.