Our Approach to Specialty

Thoughtful solutions to Specialty Care

A Condition-specific Approach to Specialty Medication for Improved Savings and Outcomes

Specialty drugs can be revolutionary and lifesaving but also costly. At Elixir, we provide a thoughtful approach to specialty care, unique to each specialty condition, that carefully considers clinical effectiveness, member experience and economic impact. To achieve optimal outcomes, we focus on four strategies:

  • Condition-Focused Clinical Controls – Specialty medications require a clinical approach that is unique to the conditions they treat; therefore, we take the specific condition into consideration when developing formularies, utilization management and other care management practices.
  • Individualized Care – Our specialty pharmacy care team engages members and their providers from the initial prescription throughout their treatment to ensure members are getting the right drug at the right time.
  • Process Integration – Elixir is completely integrated with our specialty pharmacy, sharing an adjudication platform, so that clinicians have access to a member’s full profile to reduce complications and efficiently manage transactions.
  • Meaningful Data – This integration also provides access to data and offers robust reporting insights and recommendations to identify risks and cost-saving opportunities, close care gaps and tailor member communication and support.

This approach offers our plan partners a comprehensive way to managing specialty spend and trend while maximizing effectiveness for members.