Part two of a three-part series by Sam Warman Vice President of Client Consulting at Gateway Health Partners on understanding and optimizing medical rebates.
Since medical rebates began, they have grown to become essential in offsetting the costs of specialty drugs administered in a clinical setting. Historically, because the use of these specialty medications fall under a patient’s medical benefits and their use is governed by a medical policy, these medications were not included in rebate programs, which left plan sponsors without any cost-saving strategies for these often life-saving medications.
Fortunately, this is rapidly changing with medical rebates and rising manufacturer agreements for specialty drugs, as many medications administered in a healthcare setting often account for an estimated 45% of a health plan’s total specialty pharmacy cost.
As innovative research continues to advance, more specialty drugs and biosimilars are coming onto the market, and with them, medical rebates are on the rise. For instance, in 2019 Gateway Health Partners only had 29 medications on our list of eligible agents. Today, we have contracts to manage rebates on over 100 products—a number that continues to grow.
At Gateway Health Partners, we aim to ensure you’re not leaving savings on the table. Our focus on streamlining pharmacy and medical spending helps our clients achieve compounded savings while reducing the administrative burden and providing flexible solutions to meet their business needs.
We’d love to help you navigate the world of medical rebates and optimize your cost savings.
Contact me today at [email protected] to learn more about how we can help maximize your medical rebate returns.