Pharmacy benefit alternative funding programs: Key considerations for self-funded plan sponsors
The rising cost of specialty drugs has intensified payers’ interest in innovative cost management solutions. Alternative funding programs (AFPs) have emerged as a solution to growing specialty drug spending and often project significant savings for self-funded plan sponsors. In this white paper, we provide an illustrative example that demonstrates how net specialty drug costs using an AFP can be similar to net specialty drug costs without an AFP, when considering the percentage of lives that may not be eligible for patient assistance programs, manufacturer rebates, and AFP administrator fees. We discuss:
- Some background on alternative funding programs
- Financial considerations
- Additional considerations
This report was commissioned by Genentech, Inc.
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Pharmacy benefit alternative funding programs: Key considerations for self-funded plan sponsors
Although pharmacy benefit alternative funding programs can help plan sponsors manage costs for high-cost drugs, due diligence should be conducted beforehand.