What are highly
specialized medications,
and how much
can they cost?
When a patient is diagnosed with a disease, one of the first questions that arises is, “What treatment should be followed?” In many cases, the patient will receive a prescription that includes a highly specialized medication. What are these? What are they used for? How much could they cost? Let’s delve into this matter.
What are highly specialized medications?
Highly specialized medications are those used to treat chronic conditions and complex diseases, such as cancer, hepatitis C, multiple sclerosis, and Crohn’s disease, among others.
They are usually characterized by:
- Having a high cost and being available only in pharmacies and specialized centers
- Necessitating special treatment and storage conditions
- Requiring the close oversight of a health professional to ensure the treatment is working correctly and to monitor possible side effects
- Training the patient in proper administration, for example, through an injection
- Having a high level of complexity in their preparation and manufacture
- Interferon Beta 1-a: formulated to treat multiple sclerosis, an autoimmune nervous system disease
- Etanercept: used to treat different autoimmune diseases, such as rheumatoid arthritis, psoriatic arthritis and juvenile idiopathic arthritis
- Adalimumab: used for autoimmune diseases such as Crohn’s disease, ulcerative colitis, ankylosing spondylitis
- Bevacizumab: used in treating different types of cancer, such as colon, rectal, lung and cervical
- Azathioprine: for different conditions, including preventing kidney transplant rejection and treating rheumatoid arthritis
How much can highly specialized medications cost?
Highly specialized medications are usually quite expensive, and can start at around USD 1,000 for 30 days of treatment to higher amounts of more than USD 1 million per year.
Some of the most expensive drugs in
2022, according to GoodRx, were 1 :
1 Annual cost based on long-term treatment
Zolgensma
Novartis Gene
Therapies, Inc.
USD 2.125.000
Zokinvy
Eiger Bio
Pharmaceuticals
USD 1.073.760
Danyelza
Y—mAbs
Therapeutics, Inc.
USD 1.011.882
Kimmtrak
Immunocore
Ltd.
USD 975.520
Myalept
Amryt Pharmaceuticals, Inc.
USD 929.951
With global spending on medicines on the rise, patients and their families must have insurance or a health system that can provide this type of treatment should it be necessary.
According to data from Statista, in 2010, the global spend on medicine was USD 887 million; a figure that increased in 2020, to nearly USD 1.27 billion. In 2024, it expected to approach USD 1.6 billion.
Yes. Our insurance policies could cover highly specialized medications as long as they are coordinated and pre-approved by VUMI®, within the limitations and conditions of our plans.
It is important to note that this benefit excludes medications not scientifically or medically recognized for a specific diagnosis, that are considered experimental, or the use of combinations that are not generally accepted by the scientific community.
Contact your insurance agent to learn more about our plans and their benefits.
The article does not provide medical advice. It is intended for general informational/ educational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always ask your doctors or healthcare professionals for medical advice.
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