The pharmacy landscape has evolved in recent years and 2024 is expected to bring even more challenges. Employers managing self-funded benefits should brace themselves for the onslaught by asking the following questions.
One of the biggest difficulties facing employers is the emergence of new gene therapies. While advanced gene therapies hold promise, they will create a substantial financial burden for employers. Get ahead of this trend by taking four steps.
- Proactively engage with experts in pharmaceutical management.
- Explore cost-sharing mechanisms.
- Establish robust frameworks for assessing the value and cost-effectiveness of these therapies in the context of your employee benefit plans.
- Develop a stop-loss plan to address catastrophic claims.
In addition to gene therapies, further consolidation in the pharmacy benefit management (PBM) sector presents a challenge. Giant companies are acquiring smaller shops, which can reshape the competitive landscape. Employers must stay vigilant and assess the impact of these consolidations on their benefit plans. Negotiating contracts strategically can secure more favorable terms and ensure transparency.
Amidst these challenges, the winnowing of Patient Assistance Program (PAP) funding through alternative vendors, such as Payer Matrix, poses more difficulty for employers.
Traditional avenues for PAP funding will be limited by pharmaceutical manufacturers and government regulation. Employers should explore alternative sources to support their employees’ access to essential medications. One promising alternative for affordable medications is the 340B drug pricing program.
By staying proactive and well-informed, employers can position themselves to manage costs effectively and provide comprehensive, sustainable benefits to their workforce. Oswald Companies can help. Contact us for a comprehensive analysis of your current benefits program and needs. We’ll use your benefits usage data to find the plan that works best for your employees and your budget.
Navigating the Pharmacy Benefit Landscape: Understanding Current Trends Impacting Your Bottom Line (Part 1)
Navigating the Pharmacy Benefit Landscape: Evaluating Your Needs (Part 3)
To learn more, please contact me below or learn more on our Employee Benefits page.