paul-fortunato-senior-director-of-clinical-initiatives-at-rxbenefits
Paul Fortunato, senior director of clinical initiatives, RxBenefits
6 October 2021

New captive solution for specialty drug costs

A new stop-loss supplement to manage pharmacy risk has launched. RxPharmacy Assurance provides a Vermont-domiciled sponsored captive to cover high-cost specialty drug risks. According to the company, it is designed to protect self-funded employers from the threat of “skyrocketing” prescription benefit costs.

Specialty medications now account for 80% of total medical costs, according to RxPharmacy Assurance. This results in higher premiums under traditional stop-loss insurance underwriting and can result in claims being covered for just a few months before being removed from contracts at renewal, leaving employers exposed.

“Given 44% of new specialty prescriptions target chronic conditions, employers are left financially exposed long-term, with up to 90% of claimants remaining on the plan in future years,” the company said.

RxPharmacy Assurance is a sister company of RxBenefits, a “technology-enabled pharmacy benefits optimizer” advising employee benefits consultants and providing pharmacy benefits solutions to self-insured employers.

“Self-funded employers are increasingly feeling the impact of the rising costs of specialty drugs and are in need of a complete solution,” said Paul Fortunato, senior director of clinical initiatives at RxBenefits. “Using stop-loss insurance on its own is like providing short-term and long-term disability coverage to employees, but only buying short-term disability insurance.

“RxPharmacy Assurance is designed to fill the gap where traditional stop-loss insurance falls short.”


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More on this story

Analysis
29 September 2023   Sandy Bigglestone looks back with Captive International on her first year as deputy commissioner of the Vermont Captive Insurance Division.
Analysis
30 January 2023   VCIA, Marsh and state experts to spread the word.
article
1 February 2022   He replaces Richard Smith, who led the organization for 12 years.