This section provides tools to support employers as they design or review their Specialty Pharmacy offering. This includes designing the plan, evaluating, selecting and contracting with vendor/partners, and integrating medical and pharmacy data.
Click on the links below to get started using checklists. More checklists and tip sheets are coming soon!
- Employer Checklist for Designing Specialty Drug Benefits: This checklist provides guidance to help determine if a site of care strategy is beneficial as you look at your Specialty Pharmacy offering.
- PBM Contract Checklist: This checklist highlights the criteria that should be included in a PBM contract to drive high performance and determine if your vendor/partner is delivering results focusing on Specialty Pharmacy.
- Pharmacy Benefit Manager (PBM) Audit Recommendations: This checklist covers the various types of benefit assessments/reviews commonly done and what elements should be included in a pharmacy benefit audit specific to Specialty Pharmacy.
- Site of Care Checklist: Key elements to consider when developing, designing or reconsidering your Specialty Pharmacy offering – Includes: Design features and elements, payment structures, contracting and rebate considerations, data integration and other key considerations.
Plan Member Education Strategy
When employees/plan members are faced with treatment decisions related to a complex or life-threatening disease or condition, good information and reliable resources are important. This is especially true if a specialty drug is prescribed. The Plan Member Education Strategy offers an overview of available tools and resources, and strategy implementation and measurement recommendations designed to support your efforts to educate your covered population about specialty drugs. Click on the links below to access the tools and resources.
Employee & Plan Member FAQ: This document provides answers to commonly asked questions about specialty drugs.
Newsletter Articles: These articles can be used to reinforce key messages from the FAQs. They are provided in two formats – a customizable Word document and a pdf:
Specialty Drugs: The Basics (Word document)
Specialty Drugs: The Basics (pdf format)
Understanding Your Pharmacy Benefits (Word document)
Understanding Your Pharmacy Benefits (pdf format)
It Takes A Team (Word document)
It Takes A Team (pdf format)
Take Control and Take Action (Word document)
Take Control and Take Action (pdf format)
Plan Member Education Resources
Download and use any of the following tools and resources to educate and support your covered population about conditions that most commonly involve use of a specialty drug as part of the treatment plan. These resources are in pdf format and most are customizable, providing a space for your company logo. Watch for more resources coming soon!
Inflammatory Bowel Disorder (IBD)
Psoriasis & Psoriatic Arthritis