What are Specialty Pharmaceuticals?
Specialty Pharmaceuticals are drugs/pharmaceuticals or category of drugs/pharmaceuticals, as determined by the Plan, that generally meet most of the following criteria: 1) Are produced through biotechnology or recombinant DNA technology mechanisms; 2) Are high cost (typically over $250 per dose or $1000 per month of therapy); 3) Are generally, but not always, administered by injection; 4) Require specialized patient monitoring, special handling, or unique education prior to use; or 5) Have restricted distribution procedures. Examples of drugs that qualify as Specialty Pharmaceuticals include drugs/pharmaceuticals that are used to treat Crohn’s disease, hemophilia, growth hormone deficiency, RSV, cystic fibrosis, multiple sclerosis, hepatitis C, rheumatoid arthritis, and Gaucher’s disease.
