Health Affairs, 25, no. 5 (2006): 1319-1331 doi: 10.1377/hlthaff.25.5.1319 © 2006 by Project HOPE	New Online   McAllen, TX & Beyond: An Expert Roundtable   Geography & Reform   Medicaid or Insurance Exchange?   Siren Song of New GME   Public Plan Option: Pro & Con

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Specialty Drugs

Benefit Design And Specialty Drug Use

In this paper we examine spending by privately insured patients with four conditions often treated with specialty drugs: cancer, kidney disease, rheumatoid arthritis, and multiple sclerosis. Despite having employer-sponsored health insurance, these patients face substantial risk for high out-of-pocket spending. In contrast to traditional pharmaceuticals, we find that specialty drug use is largely insensitive to cost sharing, with price elasticities ranging from 0.01 to 0.21. Given the expense of many specialty drugs, care management should focus on making sure that patients who will most benefit receive them. Once such patients are identified, it makes little economic sense to limit coverage.

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				D. P. Goldman, G. F. Joyce, and Y. Zheng Prescription Drug Cost Sharing: Associations With Medication and Medical Utilization and Spending and Health JAMA, July 4, 2007; 298(1): 61 - 69. [Abstract] [Full Text] [PDF]