SECTION9. PRESCRIPTIONDRUGBENEFITS SPECIALTYDRUGS • Specialty drugs, such as biologics that may be used to treat chronic conditions or some cancer drugs, can be quite expensiveandoftenrequirespecialhandlingandadministration. Werevisedourquestionsbeginningwiththe2016 surveytoobtainmoreinformationaboutformularytiersthatareexclusivelyforspecialtydrugs. Wearereportingresults onlyamonglargefirmsbecauseasubstantialshareofsmallfirmswereunsurewhethertheirlargestplancoveredthese drugs. – Ninety-sevenpercentofcoveredworkersatlargefirmshavecoverageforspecialtydrugs[Figure9.10]. Among theseworkers,47%areinaplanwithatleastonecost-sharingtierjustforspecialtydrugs[Figure9.11]. – Amongcoveredworkersinaplanwithaseparatetierforspecialtydrugs,45%haveacopaymentforspecialty drugsand46%haveacoinsurance[Figure9.12]. Theaveragecopaymentis$101andtheaveragecoinsurancerate is 27%[Figure9.13]. Eightypercentofthosewithacoinsurancehaveamaximumdollarlimitontheamountof coinsurancetheymustpay. • Somecoveredworkersarealsorequiredtomeetadeductiblebeforetheplancoversspecialtydrugs. Amongcovered workersenrolledinaplanwithadeductibleandspecialtydrugcoverage,29%mustmeetthegeneralannualdeductible and15%mustmeetaseparatedrugdeductiblebeforespecialtydrugsarecovered[Figure9.14]. The Kaiser Family Foundation and Health Research & Educational Trust / Page 156