A recent article, published in the Journal of Managed Care and Specialty Pharmacy (JMCP), discusses the perspectives of providers, payers, and employers regarding orphan drug access and coverage. Orphan drugs are more expensive than nonorphan treatments and account for approximately 10% of drug spending. The continued increase in orphan drug costs is a continuing and deepening challenge, especially for payers.
“Payers and employers are adopting innovative benefit designs and strategies to cover orphan drugs while maintaining plan affordability. Cost considerations are prominent factors in determining whether orphan drugs will be covered under the pharmacy or medical benefit and how providers will acquire orphan drugs.” Read more here.
(Source: Lopata et al., JMCP, June 2021)