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Wisconsin Department of Health Services

2011-2013 Medicaid Efficiencies Home

Reforms by Topic

Specialty Pharmaceutical Management

Specialty pharmaceuticals are considered to be high-cost injectable, infused, oral or inhaled biotech medications that require patient monitoring and professional support. 

These pharmaceutical are expensive and historically fall outside of traditional cost containment initiatives. Specialty pharmacy represents 25% of total Medicaid pharmacy spend and industry forecasts show that specialty pharmacy could grow to 50% of pharmacy spend by 2014. 

Wisconsin Medicaid will pursue increased controls and monitoring of these expensive biologic drugs by reviewing where these drugs are administered, implementing utilization controls, and achieving discounts through preferred purchasing methodologies.

Specialty Pharmaceutical Management (PDF, 60 KB)

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Last Revised: September 30, 2011