Express Scripts, one of the large pharmacy benefit managers, has released its 2015 Drug Trend Report. Today we will concentrate on the headline numbers. (Express Scripts Report) Overall drug spending for Express Scripts’ clients increased 5.2% in 2015. Member’s share of that spending through copays, deductibles or coinsurance declined 3.2%. For its customers who used what Express Scripts defines as a “tightly managed” drug benefit program, spending growth was only 3.3%, and 30% of its customers had flat or negative drug spending trends. The total per member per year drug spending was $1061, with $708 of that being traditional medications and $353 being specialty drugs. The traditional category had utilization growth of 1.9% and a price decrease of 2.1% for a total trend of negative one-tenth of a percent. The specialty category had a 6.8% utilization increase and an 11% price rise, for total trend of 17.7%. The company says that manufacturer consolidation, price increases on drugs with imminent patent expirations and very large price increases on older drugs with no competition contributed to ongoing unit price rises that were very high in some cases. According to the company, one-third of branded drugs had price increases in 2015 of over 20% and the average price increase on a branded medication in 2015 was 16.2%, and was 98.2% since 2011. Specialty drugs, while used by only 1-2% of the population, accounted for over one-third of all drug spending and Express Scripts expects that to rise to 50% by 2018. In the specialty category, spending growth is highest in categories like cystic fibrosis, hemophilia, sleep disorders, oncology and inflammatory conditions, which includes rheumatoid arthritis. The traditional category saw its largest spending rises in heartburn, skin conditions and diabetes, while blood pressure, high cholesterol and compounded drugs actually saw decreases. Looking ahead, the PBM expects drug trend to be 6.8% in 2016, 7.3% in 2017 and 8.4% in 2018, all heavily influenced by specialty drug spending that the company anticipates will increase by 17% a year in this time period.
✅ Subscribe via Email
About this Blog
Healthy Skeptic Podcast
Research
MedPAC 2019 Report to Congress
June 18, 2019
Headlines
Tags
Access
ACO
Care Management
Chronic Disease
Comparative Effectiveness
Consumer Directed Health
Consumers
Devices
Disease Management
Drugs
EHRs
Elder Care
End-of-Life Care
FDA
Financings
Genomics
Government
Health Care Costs
Health Care Quality
Health Care Reform
Health Insurance
Health Insurance Exchange
HIT
HomeCare
Hospital
Hospital Readmissions
Legislation
M&A
Malpractice
Meaningful Use
Medicaid
Medical Care
Medicare
Medicare Advantage
Mobile
Pay For Performance
Pharmaceutical
Physicians
Providers
Regulation
Repealing Reform
Telehealth
Telemedicine
Wellness and Prevention
Workplace
Related Posts
Commentary
Reciprocal Trade Barriers
February 13, 2025
Reciprocal Trade Barriers
Trump's imposition of reciprocal tariffs is briliant, exposing the hypocrisy of other countries that have…
Commentary
We Are Truly F**ked
February 12, 2025
We Are Truly F**ked
A bad inflation report, a bad deficit report, a bad ten-year US note auction; Trump…
Commentary
Private Equity Ownership and Health Care Prices
February 12, 2025
Private Equity Ownership and Health Care Prices
Financial investor ownership of health care providers results in higher prices.