Benchmark projections for specialty medications

Specialty medications have become a large portion of healthcare spend, consuming over $200 billion of a total estimated $480 billion in pharmacy spend per year. And spend on these medications is projected to continue rising.

In this study, Milliman’s Madeleine Cline, and Katie Holcomb provide claim cost benchmarks to illustrate the magnitude and distribution of specialty medication costs adjudicated under both the pharmacy and medical benefit for a commercially insured population.  Their findings suggest that understanding the complex and changing landscape is important for payers to effectively manage specialty medication costs.