Summer 2024
Pricing of Specialty Drugs
Specialty drug pricing significantly impacts health insurance premiums, especially with provider markups. This article compares the costs of specialty drugs from pharmacies to providers, revealing potential savings of up to $13.1 billion in 2024 when their rates match. At TPSC, we partner with PBMs to deliver innovative programs that manage prescription costs. Explore these incredible insights in this report.
![Average Provider Markup for Top Ten Specialty Drugs by Total Claim Dollars: Brand Name [Hospital Facility Markup, Professional Office Markup] / Ocrevus [75%,13%] / Keytruda [102%,29%] / Entyvio [81%,2%] / Opdivo [103%,33%] / Perjeta [97%,24%] / Tysabri [50%,3%] / Rituxan [96%,13%] / Soliris [82%,18%] / Prolia [81%,6%] / Eylea [61%,5%]](img/graph1-24Q2.webp)
5 Things Employers Should Know About COBRA and Severance Agreements as Layoffs Loom
With layoffs rising, employers must carefully navigate COBRA regulations and severance agreements to avoid compliance issues. COBRA basics include providing continuing coverage for employees and their dependents for up to 18 or 36 months after a qualifying event, such as termination. However, employers offering COBRA subsidies as part of severance packages should examine various factors, including the duration of coverage, tax implications and non-discrimination rules. Here are five key considerations for employers to ensure compliance and minimize legal risks.
Employees & Employers Only Care about Benefits When They Need to
Most employees only think about their benefits when they need them, while employers typically focus on benefits only during open enrollment. This lack of engagement is a critical issue, especially given that companies spend $1,000-$3,500 per employee annually on software tools, including benefits platforms. By leveraging technology, personalized communication and ongoing support, employers can ensure that benefits are understood and effectively utilized throughout the year. Explore TPSC’s member resources for guidance on optimizing benefits engagement.
$1,000 - $3,500
Companies spend $1,000 - $3,500 per employee
annually on software tools.
Five Habits of the Healthy Health Plan Fiduciary
In the ever-changing world of healthcare, health plan fiduciaries must stay vigilant to avoid costly risks and ensure compliance. This comprehensive checklist offers five crucial actions, from identifying responsible fiduciaries to enhancing claims decision processes to maintain the effectiveness and success of your organization’s health plan. Find out how to strengthen your fiduciary health and confidently navigate the complexities of healthcare administration in 2024.
Medicare Spending on Ozempic and Other GLP-1s Is Skyrocketing
Medicare spending on GLP-1 drugs has surged dramatically, with costs rising from $57 million in 2018 to $5.7 billion in 2022. Initially developed for type 2 diabetes, these drugs are now highly sought after for weight loss and other potential health benefits. The high costs, with list prices over $11,000 annually, are causing concern about the financial impact on Medicare and other insurers. As demand grows, the strain on Medicare spending and Part D premiums is expected to increase further.
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