A recent report by Vizient expects that hospitals will see a nearly 3.5% increase in pharmaceutical spending next year. Much of this increase can be attributed to medications for diabetes and neurological conditions, along with specialty drugs such as those for cancer treatment. Among those drugs impacted include medications that treat multiple sclerosis, migraines, rheumatoid arthritis, and Crohn’s disease.
On the other hand, a few medications are expected to decrease in cost. One such drug is Veklury, which is used to treat COVID-19. This is good news for individuals who have been hospitalized with this condition since COVID-19 drugs were once quite expensive due to shortages during the pandemic.
The good news is that The Inflation Reduction Act aims to counteract some of these pricing increases in the coming year. Firstly, this legislation encouraged a cap on Medicare Part D out-of-pocket costs. Since the cap starts in 2024 – just as many of these prices are scheduled to rise – members will receive some limit-based protection from pricing increases. From 2025 on, CMS plans to drop the annual cap to $2,000 and regulate it from there on out.
Both pricing increases and decreases undoubtedly have the potential to impact health insurance plans and programs. Insurers can provide their members with a good balance amid these changes by stabilizing their own prices and maintaining member satisfaction. Insurers can do this by adding to their provider network while encouraging their members to take advantage of in-network discounts. In addition, insurers can focus on outreach:
- Offering consultations with their members to help them choose the most cost-effective plans.
- Providing comprehensible, actionable education surrounding the benefits of each plan so members take full advantage of them.
- Partnering with reliable clinicians to build a strong provider network that serves members through comprehensive care.