Whether it’s the special handling of the drug or a certain $ amount selected to categorize a specialty product, everyone has a different definition of specialty drugs. A review was done on the top 3 PBM’s lists to see how different they really are. Drugs identified as specialty for each PBM ranged from 400 to over 600 drugs. Findings showed that some PBMs excluded certain therapy classes (i.e. HIV, transplant, hemophilia) while others included them and some included repackaged NDCs (i.e. Humira, Orthovisc, Arixtra) while others did not. What does this mean to you? A lot considering that specialty rebates are carved out of your traditional mail and retail rebates and in most cases paid at the script level. Retail and Mail traditional rebates can range from $30-$150/script whereas specialty is upwards of $300-500/script. Contact RemedyOne so that we can evaluate your business and see if there is opportunity for you.
