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Board hears specialty-drug pressure and a projected excise-tax swing from blending retirees
Summary
Aon and plan representatives reported specialty drugs are a growing share of pharmacy spend (Blue Shield ~26%, Kaiser ~31%), and Aon's excise-tax update showed that federal blending guidance could reduce San Francisco's 2018 excise-tax exposure from roughly $11.8 million to approximately $465,000 under their assumptions.
Board members were briefed on two topics with major budget implications: the rapid rise of specialty-drug spending within pharmacy and an updated excise-tax projection that depends heavily on federal guidance on "blending" retiree pools.
Paige Sipes Metzler (Aon) said specialty drugs already represent a substantial and growing share of pharmacy spending: she reported Blue Shield's specialty spend at about 26.2 percent and…
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