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Home Medicare

Balancing Breakthroughs With Rising Costs

by TheAdviserMagazine
5 months ago
in Medicare
Reading Time: 1 min read
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Balancing Breakthroughs With Rising Costs
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Biosimilars: A High‑value Opportunity

Alternatives to biologic medications, known as biosimilars, offer the same safety and effectiveness as the original drugs, and similar to generic drugs, they drive market competition.

Why this matters to your plan:

Biosimilars introduce market competition, driving down prices.
They offer more cost‑effective treatment options for conditions like cancer, rheumatoid arthritis, and Crohn’s disease.
IBX employs preferred drug strategies and exclusive contracting with biosimilar manufacturers to maximize cost savings.
We’re actively monitoring and identifying opportunities to leverage biosimilars to maximize our cost savings opportunities for our clients.

Site of Care: Responsible Steering

One of our most powerful tools in combatting rising specialty drug costs on the medical benefit is managing the site of care through our MCES program. For many specialty drugs administered by a health care professional, administration in a doctor’s office, infusion clinic, or in the home via a nurse is not only more convenient to the member, but also significantly reduces costs.

The MCES program has saved over $250 million since 2012. Our Utilization Management procedures and provider contracting facilitate site of care coordination and significantly reduce the added costs associated with the administration of high‑cost medical specialty drugs.

What This Means for You

As an employer, you want to offer benefits that meet the evolving needs of your employees without compromising plan sustainability. IBX supports you with:



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