Specialty RxGuidance


The Specialty Drug Problem

Rising Costs

The trend of rising pharmaceutical costs will continue, driven by expensive specialty drugs.

Physicians can be influenced

Prescribing physicians can be influenced by pharmaceutical representatives and rarely have current information regarding the cost of drugs to the member or the plan.

Conflict of Interest

Conflicts of interest abound since Pharmacy Benefit Management companies have financial ties to pharmaceutical manufacturers and many even own their own specialty pharmacy.

Members can be influenced

Members can be influenced by specialty drug advertising, creating demand for high-cost drugs with no knowledge of their cost or less expensive alternatives.
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RISING COSTS

The trend of rising pharmaceutical costs will continue, driven by expensive specialty drugs.
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PHYSICIANS CAN BE INFLUENCED

Prescribing physicians can be influenced by pharmaceutical representatives and rarely have current information regarding the cost of drugs to the member or the plan.
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CONFLICTS OF INTEREST

Conflicts of interest abound since Pharmacy Benefit Management companies have financial ties to pharmaceutical manufacturers and many even own their own specialty pharmacy.
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MEMBERS CAN BE INFLUENCED

Members can be influenced by specialty drug advertising, creating demand for high-cost drugs with no knowledge of their cost or less expensive alternatives.
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By the Numbers

291 of 533 new drugs expected to seek FDA approval by 2020 are specialty drugs.
Treatment regimens can be very costly, some reaching as much as $750,000/year.
The average annual cost increase of Specialty Drugs is 21% based on a three year trend.

So, what's the solution?

Independent, Unbiased
Prior Authorization of Specialty Drugs

RxResults removes the
conflict of interest.

Our model is designed to make certain the right member meeting the right clinical criteria gets the right drug at the right time in an effort to achieve the best clinical outcome.

RxResults has a marked advantage due to their relationship with the nationally recognized University of Arkansas for Medical Sciences.

RxResults provides independent, non-biased clinical prior authorization review of specialty drugs. PBMs still provide pharmacy benefit management services & specialty pharmacy services, including fulfillment of specialty drugs.

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