Orphan Drugs

Orphan Drugs: Managing Utilization for Optimal Outcomes

Orphan Drugs: Managing Utilization for Optimal Outcomes

BY KATHRYN KOLONIC, DO, MPH, CPHQ

ALLMED VICE PRESIDENT & MEDICAL DIRECTOR

In the United States, the average annual cost of drugs to treat rare medical conditions—so-called orphan drugs—is 25 times higher than that of traditional drugs.1 As the number of orphan drugs grows and their uses proliferate, these high costs are having an outsized impact on payer, health plan, and member budgets.

In response, Medicare and payers across the board are implementing access controls and cost-sharing strategies, based on a variety of factors, to ensure appropriate use. Developing a treatment plan with confidence in this environment requires specialized expertise…

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