Biotech injectable drugs: clinical applications and financial effects

Biotechnology-derived injectable medications raise complex issues with respect to access and administration for both manufacturers and payers. In addition, biotech injectables rarely fit within traditional prescription drug benefit design structures, thereby creating inequities in reimbursement and access that can undermine a health benefit plan's goals.Benefit-design changes focusing on short-term solutions can exacerbate such situations. Employers, insurers, and managed care organizations need to consider innovative benefit-plan designs to effectively address issues that are associated with biotech medications.Actuarial models, such as the Reimbursement model described in this article, can help to provide the options analyses and decision-making support that are required.