Health Affairs

Health Affairs, 24, no. 4 (2005): 1117-1127 doi: 10.1377/hlthaff.24.4.1117 © 2005 by Project HOPE	New Online   Reinhardt: Post-Summit   Report from the Summit   President's Reform Proposal   Rising Medicare Costs   Spending for Immigrants   $2.5 Trillion U.S. Health Tab   Child Obesity Briefing

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DataWatch

Variability And Growth In Spending For Outpatient Specialty Pharmaceuticals

C. Daniel Mullins, Andrea R. DeVries, Van Doren Hsu, Fanlun Meng and Francis B. Palumbo

Specialty pharmaceuticals are a unique group of drug agents used to treat complex clinical conditions. Many specialty pharmaceuticals are biological in nature and administered through injection or infusion. Tracking spending on these pharmaceuticals is complex, because these products may be processed as either medical or pharmacy claims. This benchmarking study of ten Blue Cross Blue Shield plans, representing almost eighteen million covered lives, documents large expenditures on select specialty pharmaceutical categories and much variation in spending across plans, age groups, and time. Our results underscore the need for insurers to scrutinize trends in specialty pharmaceutical spending and identify appropriate management strategies.

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