Healthcare Economist January 16, 2025
A recent paper by Kacerek and Mattingly (2025) aims to answer why certain drugs are defined as “specialty” drugs and others are not. They first cite an Office of the Inspector General (OIG) report:
The OIG found that there was no standard definition in Medicaid and that Medicaid programs used more than 100 different characteristics to categorize specialty drugs.
Despite the lack of a standard definition, the OIG found that most specialty drugs across Medicaid programs shared the following characteristics. Such drugs: are expensive; are used for rare, complex, or chronic conditions; require specialty handling; require specialized administration by a clinician; and are dispensed through a specialty pharmacy rather than traditional retail.
The authors go on to describe...
Today's Sponsors
Today's Sponsor