CINCINNATI, OH, March 4, 2024 – Custom Design Benefits, a leading third party administrator providing innovative cost containment solutions for self-funded employers, is pleased to announce a strategic partnership with Emerging Therapy Solutions® (ETS) to help employers manage the high costs associated with treatments for rare genetic and complex diseases.
With many new cell and gene therapies approved by the FDA and more expected in 2024, it has never been more critical for employers to make sure they have a plan in place to help them prepare for these emerging therapies, said Julie D. Mueller, President and CEO of Custom Design Benefits.
“Our partnership with ETS highlights our commitment to supplying employers with the solutions they need to stay ahead of the accelerating growth in cell and gene therapies and other high-cost treatments,” Mueller said. “Through this relationship, we will be able to keep our clients updated on potential risk factors and provide expert data and resources on standards of care and expected costs.”
ETS will provide customized forecasts to estimate the risk and utilization of emerging therapies, patient identification modeling, along with clinical and underwriting guidelines for the complex and catastrophic conditions these therapies can treat.
“Our solutions deliver an evaluation process designed to ensure patients can access the right therapy at the right time with negotiated pricing at identified programs of excellence,” said Ashley Hume, Chief Commercial Officer of ETS.
More often than not, prescription drug costs encompass a larger share of an employer’s medical spend each year. According to the nonprofit Business Group on Health’s 2023 Large Employers’ HealthCare Strategy and Plan Design Survey report, prescription drugs accounted for a median of 21% of employers’ health care costs in 2021, with more than half of their pharmacy spend going to high-cost specialty medications used to treat complex and chronic conditions.
To help employers better control these costs, Custom Design Benefits began partnering with industry leaders in 2017 to offer advanced pharmacy cost containment strategies. In addition to improved risk management for complex and rare cell and gene therapy treatments, these strategies include:
• A strong pharmacy benefit manager (PBM) contract that directs revenue back to the employer
• Carving out prior authorization of all specialty medications to an independent third party
• Copay assistance language
• Alternate funding programs
• Reference-based pricing for non-specialty medications
• Solutions for complex and rare cell and gene therapy treatments
To learn more about these strategies and how they can help control pharmacy costs, visit customdesignbenefits.com.
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About Emerging Therapy Solutions®
Emerging Therapy Solutions® (ETS) helps reinsurance and stop-loss payers, health plans and self-funded employers manage the risks associated with high-cost therapies for rare and complex conditions. ETS offers a comprehensive suite of services for solid organ and bone marrow transplants, cell and gene therapies, and other highly specialized therapies.
For more information about ETS and their groundbreaking work in gene and cell therapy, please visit emergingtherapies.com.
About Custom Design Benefits
Custom Design Benefits (CDB) is a third-party administrator (TPA) of self-funded health benefit plans. Founded in 1991, it is the area’s largest independent, full-service TPA of such plans. Through self-funding, CDB assists employers in taking back control by creating a plan that is uniquely designed for their workforce, thereby obtaining cost savings.
You can learn more about Custom Design Benefits’ innovative and personalized service approach to sustainable medical benefits at customdesignbenefits.com.