Group Health hosts Prescription & Specialty Drug Forum

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Group Health's Prescription & Specialty Drug ForumOn Sept. 28, Group Health brought together national and local business and health care leaders to discuss the impact that rising prescription drug costs have on companies. Entitled the Prescription & Specialty Drug Forum, the event gave producers and employers an opportunity to learn how the pharmaceutical industry is affecting drug prices—and what can be done about it.

In his opening remarks, Group Health President and CEO Scott Armstrong said, “This is what Group Health does. We take on the tough issues and honestly and thoughtfully dive into them. When you bring together like-minded leaders who are all committed to confronting the issues in front of us, it’s actually the only way we change the system. It’s the only way we change the world.”

To set the stage, Group Health Executive Vice President Bob O’Brien noted that, “Nationally, pharmaceuticals represent as much as a quarter of employers’ benefit expense. And that according to a Kaiser Family Foundation tracking poll, 1 in 4 Americans are having a difficult time affording their medicine.”

Why are prescription drug prices climbing at such an alarming rate?

Keynote speaker Ceci Connolly, president and CEO of the Alliance of Community Health Plans (ACHP), cited three main causes:

  • The high introductory costs of specialty drugs (one hepatitis C drugs costs $84,000 for a course of treatment).
  • Pharmaceutical companies raising the prices of established drugs by drastic amounts (think of EpiPens going up by 500 percent in price).
  • The dramatic price increase of some brand-name drugs (seven brand-name drugs used to treat diabetes increased in cost from 93 percent to 325 percent over a 5-year period).
cost-of-diabetes-drugs-2010-2015

High costs affect both brand-name and generic drugs and span therapeutic areas. This graphic focuses on brand-name diabetes drugs, with no generic options yet available for insulin in the U.S.

Ms. Connolly went on to say that ACHP members, such as Group Health, have developed ways to ensure that patients receive effective—and cost effective—medication whenever possible. Three strategies in particular stand out: care coordination, medication therapy management, and physicians taking an active role in helping to manage prescribed medications.

Guest speaker Jonathan Hensley brought a unique viewpoint to the event. As former head of Regence Blue Shield in Washington and current president and chief strategy officer at Capital Benefits, he has seen the issue from both health plan and company perspectives.

“Our clients are well aware that pharmacy costs are now making up 18, 19, and possibly 20 percent of their health care costs,” Hensley noted. “They’re looking for a partner to take action on their behalf. So we’re looking to work with health care organizations that see things in a very integrated way. This is where Group Health shines.”

During a panel discussion, Marc Mora, MD, Group Health chief medical officer, provided concrete examples of what Group Health is doing to help manage rising prescription and specialty drug costs. These range from pharmacy expertise in such specialty areas as multiple sclerosis and complex oncology medications to strict monitoring of dosing, adherence, and effectiveness. The result is providing the right prescription at the right time for the right cost.

For those interested in the keynote presentation, here is Ceci Connolly’s slide deck. You can also watch highlights from the Prescription & Specialty Drug Forum.