"In this report, required by Section 130 of Chapter 47 of the Acts of 2017, the Massachusetts Health Policy Commission (HPC) examines the prevalence and impact of health insurance payer policies that seek to reduce overall pharmaceutical spending by requiring alternative methods of distribution and payment for certain costly specialty drugs. The specific drugs subject to these policies are not those typically dispensed by a retail pharmacy directly to a patient, but instead are administered by a clinician to a patient through injection or infusion in the outpatient setting (e.g. chemotherapy injections). These clinician-administered drugs are typically high priced and represent a growing share of all pharmaceutical spending in Massachusetts and the U.S."