Integrated Medical, Pharmacy Claims Give Full View of AI Class

Some companies that analyze specialty drug spend do so with a focus solely on the pharmacy benefit. This approach, however, may fail to take into account a significant amount of medical benefit spending within certain conditions, including inflammatory diseases. A recent study by Prime Therapeutics LLC revealed trends across both benefits for the conditions, which account for almost 20% of all pharmacy and medical benefit drug expenditures among Prime’s commercially insured book of business. It also demonstrated that the class may benefit from indication-based pricing.

The study was presented at the Academy of Managed Care Pharmacy’s AMCP 2021 virtual conference in April.

Angela Maas

Angela has an extensive background of editing, reporting and writing for trade and consumer publications. She has written Radar on Specialty Pharmacy (formerly called Specialty Pharmacy News) since she joined AIS Health in 2005 and has broad knowledge of the various issues at play within the space. Before joining AIS Health, she was managing editor at Employee Benefit News and Employee Benefit News Canada and managing editor at HemAware (a hemophilia publication), Lupus Living and Momentum (a multiple sclerosis publication). She has a B.A. in English and an M.A. in British literature from Arizona State University.

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