title: Beyond the myths: finding benefit design solutions that address the true costs of high healthcare use.
abstract: Chronic and severe health problems place an enormous financial burden on individuals, employers, and health plan providers, requiring all to make tough decisions about healthcare. Specialty pharmaceuticals are increasingly attractive treatment options, but employers need tangible ways to incorporate these medications into benefit plans. Benefit managers can take a proactive role in addressing cost and compliance issues, using evidence-based data about true patient costs to develop policies that encourage employees to seek appropriate care. Achieving savings in direct and indirect costs will require more than shifting coverage, which can lead to nonadherence and increase costs elsewhere.
authors.affiliation: HealthCore, Wilmington, Delaware, USA.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Willey
authors.forename: Frank
authors.initials: F
authors.lastname: Kopenski
authors.forename: Grant D
authors.initials: GD
authors.lastname: Lawless
mesh_terms: D000208:Acute Disease / Q000191:economics* / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D001688:Biological Products / Q000191:economics; D001709:Biotechnology / Q000191:economics*; D002388:Catastrophic Illness / Q000191:economics; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology; D015897:Comorbidity; D003669:Deductibles and Coinsurance / Q000706:statistics & numerical data*; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D008875:Middle Aged; D017059:Models, Econometric; D014481:United States
chemical_list: D001688:Biological Products