The rising cost of Rx drugs are a big concern for everyone.
- The public pays higher costs at the drugstore.
- Employers spend more to keep employees insured.
- Insurance companies try to cover meds while holding down premium costs.
- And, taxpayers bear the cost of prescription drugs that are part of government programs like Medicare and Medicaid.
The issue is not going away. It’s fueled, in part, by the increase in specialty drugs.
These drugs zero in on scientific breakthroughs on how the body works and offer new hope for those with chronic conditions and rare diseases. But, like all medical advancements, they come at a high cost.
Specialty drugs aren’t used by many people, but their high price tag affects all members. Only 1 in every 500 BCBSND members use these drugs, but those costs account for nearly one-third of all BCBSND Rx spending.
As a company, we’re wrestling to balance two very important commitments:
1. Our mission is to keep health care affordable for all those we serve.
2. At the same time, we want to ensure that people have timely access to safe, effective medications when they need them, whether the drugs cost pennies or thousands of dollars.
Our strategy to balance those commitments includes:
Information to help you manage costs
As a member, there are things you can do to save on your personal Rx costs, but BCBSND also works to control costs for our entire membership base.
Assisted by medical expertise and health data, BCBSND uses a drug formulary to connect members with the most effective drugs at the lowest possible price. (Get more information on formularies.)
Help members improve outcomes
Many plans include pharmacy benefit management to help members do things like identify potential drug-related problems, answer questions and offer medicine education. And of course, making sure members have access to the meds they need is key to that.
Without tight management and constant attention, these drugs could ultimately become uninsurable, but we are committed to pursuing solutions that keep this benefit sustainable.