Payers and pharmacy benefit managers (PBMs) are actively looking to manage this class of drugs in order to deal with the increasing specialty drug trend. As a result, they are increasingly employing utilization management programs such as prior authorizations for high-cost, provider-administered injectables and are now starting to drive utilization toward preferred formulary agents through this process. PBMs such asCatamaran and Humana’s PBM are involved in novel tactics to control spending. These include ecialty pharmacy point-of-sale interventions such as dose optimization and management, patient assessments before refilling the drug, and programs aimed at improving patient adherence as a way to contain costs.

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