Managed Care — Plan sponsors are wasting $4.9 billion annually as a result of inadequate management of specialty medications in the medical benefit, according to our estimates using MarketScan data. Most of these costs could be avoided by applying the utilization- and trend-management programs that are traditionally found in the pharmacy benefit to the medical benefit, according to the data analysis by Express Scripts. The Express Scripts analysis was based on 2011 MarketScan data of specialty medication utilization across the United States.