Research finds use of a specialty pharmacy connected to Medicare Advantage beneficiaries’ health plans was associated with receiving key medications nearly a week sooner and out-of-pocket cost savings of more than $100.

A new peer-reviewed study from Humana Healthcare Research published in Health Affairs Scholar found that Medicare Advantage beneficiaries who used an integrated specialty pharmacy, which coordinates pharmacy services with a beneficiary’s health plan, experienced faster access to specialty medications and lower out-of-pocket pharmacy costs compared with beneficiaries using non-integrated specialty pharmacies. The research suggests that greater coordination between health plans and specialty pharmacies can help improve the patient experience and make prescription drugs more accessible and affordable.

The study, conducted by Humana Healthcare Research, analyzed data from more than 23,000 Humana Medicare Advantage beneficiaries receiving specialty medications through CenterWell Specialty Pharmacy®. Specialty medications are typically more expensive than traditional prescription drugs and used to treat complex conditions such as rheumatoid arthritis, psoriasis, HIV and osteoporosis. Researchers found that integrated specialty pharmacy care was associated with:

Nearly six days faster access, on average, to specialty medications compared with non-integrated specialty pharmacies.
Approximately $106 lower annual out-of-pocket pharmacy costs for beneficiaries compared to those using non-integrated specialty pharmacies.

The research also demonstrated that beneficiaries receiving care through a fully integrated model that incorporates primary care in addition to specialty pharmacy and the health plan led to approximately $165 lower annual pharmacy costs compared with beneficiaries using non-integrated specialty pharmacies.

"For people managing complex health conditions, waiting for a medication is the same as waiting to start treatment," said Dr. Sanjay Shetty, President of CenterWell, Humana’s health services organization. "This research suggests that when pharmacy services, primary care providers and health plans work together more closely, patients can get the medications they need faster and at a lower cost."

The full study is available in Health Affairs Scholar.

About Humana Healthcare Research

Humana Healthcare Research is a team of expert researchers dedicated to transforming healthcare through impactful, data-driven insights. As a subsidiary of Humana, Humana Healthcare Research collaborates with leading academic and industry partners to advance and shape innovation in care delivery and health policy for better outcomes.

About Humana

Humana (NYSE:HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health, delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel and communities at large. Learn more about what we offer at Humana.com and CenterWell.com.

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