Specialty Management

The complex treatment and high cost of specialty drugs are driving tremendous change in pharmacy and drug therapy management. As specialty drug use grows, and its contribution to drug trend also increases, innovative strategies and solutions are needed.

MedImpact Direct Specialty: End-to-End Specialty Drug Management

MedImpact Direct Specialty offers end-to-end specialty drug management for Plan Sponsors. We work with our clients to understand their goals and help develop high-impact drug management strategies to more effectively contain costs in an era of high-cost, innovative drug development. We monitor drugs throughout the product lifecycle from pipeline through dispensing, and conduct clinical surveillance for better care and waste reduction.

Tightly Managed, Unique Network for Specialty Management

MedImpact delivers prescription-level utilization management for specialty drugs clients won’t get with other PBMs. We do not own specialty or mail order fulfillment pharmacies, as we believe there is an inherent conflict. Instead, we provide a unique, competitive network of specialty pharmacy providers that provide fulfillment for specialty through one source, or a single brand, MedImpact Direct Specialty, to help members navigate their specialty medication needs.

Narrowing our specialty pharmacy network through a single brand via one source, MedImpact Direct Specialty gives clients better control over member experience and utilization, and lower costs through deeper discounts and waste mitigation.

We Control Costs & Utilization

MedImpact Direct Specialty is a key component of our single source, low-net-cost strategy in response to client demands for better control over specialty spending. We lower costs by managing appropriate utilization. As the client advocate, we:

  • Provide prescription-level utilization management per plan goals
  • Reduce waste
  • Lower cost through preferred provider rates
  • Offer clinical programs for better care

Prescription-Level Utilization Management™

The MedImpact Direct approach centers on control of every specialty referral routed through its unique network of providers. MedImpact Direct Specialty reviews every referral and applies strict utilization management per client-defined protocols. We route the referral, and provide formulary information, prior authorization forms, and lower cost alternatives to the dispensing pharmacy to adhere to client-defined plan guidelines. The specialty pharmacy provides patient care management and dispenses the drug. MedImpact Direct Specialty applies Clinical Management retrospectively to identify gaps in care or incomplete regimens, suboptimal drug treatments and overutilization.

For more information, go to: www.medimpactdirect.com