Provider-administered drugs are complex therapies indicated for the treatment of a variety of disease states across multiple specialties, including gastroenterology, immunology, neurology, oncology, ophthalmology, and rheumatology. In recent years, employers, plans, and pharmacy benefit managers (PBMs) have continued to evolve their strategies for controlling specialty drug spending. Specifically, many large health plans, many of whom own PBMs and specialty pharmacies, increasingly require that drugs previously purchased directly by practices be filled by a PBM-owned specialty pharmacy, bypassing the traditional acquisition model of “buy-and-bill.”

Avalere’s white paper entitled “Payer White-Bagging Requirements: Considerations for Access to Infusion Care” highlights the potential financial impact of specialty pharmacy acquisition models. Through primary research, Avalere examined estimates of the financial effects of white bagging as a growing model for acquisition and delivery of provider-administered drugs and costs experienced by infusion practices, payers, and patients. Avalere surveyed a range of practices, from smaller community practices to multi-site systems.

To learn more, download the white paper.

Funding for this research was provided by National Infusion Center Association, Infusion Providers Alliance, and The US Oncology Network. Avalere retained full editorial control.