New captive solution for specialty drug costs

06-10-2021

New captive solution for specialty drug costs

Paul Fortunato, senior director of clinical initiatives, RxBenefits

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.”

stop-loss, RxPharmacy Assurance, drug risk, pharmacy, drug, self-insured, Vermont-domiciled, risks, RxBenefits, medications, North America

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