Health Insurance

Health insurance premiums in Massachusetts are expected increase between 8 and 13 percent, driven primarily by the cost of expensive specialty drugs. The premium increases are expected to affect the rest of the country as well.

According to a recent article by the Associated Press (published by the Insurance Journal, here), specialty drugs accounted for 19 percent—about $40 billion—of pharmaceutical spending last year. Express Scripts, a company that manages prescription programs, estimates that by 2009, that $40 billion figure will inflate to $90 billion, as new drugs and treatments emerge.

Specialty drugs: Biotechnology treatments involving genetic engineering, unique treatments for rare diseases, cancer medications that have to be administered in medical facilities and other high-cost treatments.

Matthew Connell, the senior director of pharmacy services for Blue Cross and Blue Shield of Mass., told the Boston Globe, "The specialty drug slice of the pie is growing fast. It's only about half of one percent of all pharmacy [prescriptions], but it accounts for as much as 13 percent of pharmacy costs."

According to the AP, insurance companies, have, in the past, cited the rising costs of prescription drugs, higher costs from doctors and imaging technology for the increase in health insurance premiums. This is the first time they've included specialty drugs into the contributing factors.

Insures are trying to hold down the cost of health insurance premiums by taking efforts to control the use and cost of specialty drugs, reports the AP. Such efforts include requiring physicians to obtain permission before prescribing specialty drugs and barring the prescription and use of drugs not approved by the Food and Drug Administration (FDA).

Read the full AP report courtesy of the Insurance Journal here.