Express Scripts 2015 Drug Trend Report

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.