Specialty Drugs Bite Texas School District

Texas school district seeking stop loss proposals faces significant additional risk exposure through specialty drug lasers.

A large 4,500 life self-funded Texas school district administered by Blue Cross, is out for proposals for stop loss coverage. One plan member is on an expensive specialty drug. Spinraza is among the most expensive drugs in the world costing $750,000 in the first year and $375,000 a year after that, and needs to be taken for a lifetime.

There’s more specialty drug risk exposure in addition to this one.

We’ve been keeping track of this district’s plan performance for the past five years during which their paid claims have increased from $19,000,000 to $43,000,000. They have not gone to bid in that time period, relying on Blue Cross to control their health care spend. That hasn’t happened.

It’s destined to get worse. They could do better.