Specialty Eye Care: Healthcare's Next High-Cost Frontier

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As high-cost retinal therapies, gene and cell therapies, sustained-release implants, and other emerging technologies reshape eye care, health plans are facing many of the same challenges that transformed oncology: escalating drug costs, increasingly complex care pathways, and growing pressure to balance outcomes with financial sustainability.

Specialty eye care is becoming healthcare’s next high-cost specialty risk area. Successfully managing it will require a comprehensive approach – one that combines value-based reimbursement, evidence-based specialty drug management, and site-of-care optimization to support outcomes while controlling costs.

During this panel discussion, our experts share how health plans may be able to:

• Reduce total eye care costs – perhaps by as much as 30% – through value-based reimbursement and specialty management strategies
• Lower pharmacy costs – potentially by as much as $1.6 million per 100,000 members – through first-line therapy protocols and specialty pharmacy management
• Save on surgical costs by up to 40% through more effective site-of-care management

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