The rising cost of specialty pharmaceuticals presents a growing concern for payers across the healthcare ecosystem. As more innovative and complex therapies enter the market, particularly in the areas of rare diseases—including autoimmune disorders, chronic conditions, and oncology and hematology-related conditions—the economic burden continues to expand. Specialty drugs now account for over 50% of total prescription drug spending despite serving a comparatively small percentage of the patient population. Without a strategic approach to cost containment, payers face increasing difficulty balancing access, affordability, and budget sustainability.
From optimizing site-of-care decisions to leveraging advanced analytics and implementing value-based contracts, this white paper will examine a range of challenges and actionable strategies for payers to manage specialty drug costs more effectively—with a core focus on integrating effective cost-control methods to improve clinical outcomes and increase member satisfaction.