16 Jan specialty drug spend 2019

© 2021 Evernorth Health Inc. All Rights Reserved. By 2016, 3 out of every 5 new drugs approved by the Food and Drug Administration (FDA) will be specialty drugs. Through smart formulary and utilization management strategies we mitigated the impact of price inflation, prioritized lower-cost and generic options when clinically appropriate, and delivered negative price growth for non-specialty drugs and very low price growth for specialty drugs. Adherence and health outcome results, savings projections and performance ratings are based on CVS Caremark data. Data and market trends suggest this shift will extend ... 4 The Health Management Academy, “Trends in Specialty Pharmacy: 2019 Health System Executive Brief.” (2019, June). Most importantly, our focus on patient care delivered better health and savings for patients and plans in 2019, as we: Scroll down for these and other data insights. PSG’s State of Specialty Spend and Trend Report details specialty drug utilization and gross spending through the lens of PSG’s proprietary Artemetrx ® platform, which provides an integrated view of specialty costs. For 10 years, the Magellan Rx Management Medical Pharmacy Trend Report has unlocked pharmacy trend updates and emerging strategies to manage rising specialty spend on the medical benefit. The Policy describes how you can control the use of cookies at any time. Clients who opted for tighter management reduced trend even more. Cost can be a barrier to adherence and can force tough decisions about whether or not to fill a prescription. We helped keep member costs low with formulary designs that prioritize lower-cost products, and solutions such as $0 copay preventive drug lists and point-of-sale rebates, which enables clients to pass on all or a portion of the rebates we negotiate from manufacturers to members during the deductible phase. A report by America's Health Insurance Plans (AHIP) projected that drug spending in the US will grow to $590 billion by 2020, up from $337 billion just a few years ago. At 1.4 percent, overall trend in 2019 was the lowest in five years, despite increases in prescription utilization and ongoing manufacturer-driven price inflation. While private drug plans spent more on specialty medications in 2019, that amount was lower than 2018’s 6.9 per cent increase. In 2017, among adults aged 18–64 who were prescribed medication, women were more likely than men to use selected strategies to reduce their prescription drug costs. In 2019, Part D enrollees’ average out-of-pocket cost for 11 orally administered cancer drugs was $10,470, according to the JAMA study. Companies are proactively examining and leveraging a range of options to manage the relentless rise of pharmacy spend driven primarily by increased specialty drug costs. Executive Vice President and President, CVS Caremark. Specialty medications include injectable and non-injectable drugs typically used to treat chronic, complex conditions. https://www.fda.gov/drugs/new-drugs-fda-cders-new-molecular-entities-and-new-therapeutic-biological-products/novel-drug-approvals-2019 Accessed Feb 2020. Fee-for-service spending accounted for 61% of total Medicare spending in 2019, down from 67% in 2016. Specialty drugs are used for the treatment of complex, chronic, or rare conditions such as cancers and hepatitis C. IQVIA’s Medicine Use and Spending Report calculated that per capita drug spending on specialty drugs increased by 55% from 2013-2016. Together, they bring the promise of simplicity, predictability and, above all, affordability to high-priced insulin, gene therapies and the emerging world of digital health – for 2020 and beyond. Utilization of specialty drugs is highly concentrated, accounting for only 2.2% of prescriptions but 48.0% of expenditures. This was due to new therapies entering the market with few or no competing drugs to drive down prices. Net spending on specialty drugs in Medicaid roughly doubled from 2010 to 2015, rising from $4.8 billion to $9.9 billion. Solutions to Mitigate the Cost of Gene Therapies, Digital Tools, Nurse-led Care Improve Outcomes, CVS Health Pharmacy Benefit Management Twitter Page, CVS Health Pharmacy Benefit Management LinkedIn Page. Despite continuing increases in drug prices and new million-dollar therapies, Express Scripts has kept annual spending increases for prescription drugs below 3% for the past 3 years – at or lower than the Consumer Price Index. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Spending on specialty drugs is concentrated in mail-order pharmacies, retail pharmacies, clinics, and nonfederal hospitals. The use of specialty medicines grew by 5%, more than twice the rate of other drugs, and now represents 2.2% of volume. The Express Scripts Prescription Price Index (PPI) measures inflation in prescription drug prices by monitoring changes in list prices for a fixed market basket of commonly used prescription drugs. Specialty drug spend forecast: The stakes are high. For the eight specialty drugs in our analysis in both years where Part D enrollees can expect to pay more out-of-pocket in 2019 than in 2016, median annual cost … After that, two more brands are expected to gain FDA approval, driving unit cost trend up in 2022 as utilization steadily increases. Client-specific modeling available upon request. This was due to new therapies entering the market with few or no competing drugs to drive down prices. Employers’ most daunting challenge and uncertainty when it comes to dealing with pharmacy spending is the specialty drug impact — specifically, new million-dollar therapies getting approved by the FDA. Specialty trend … Specialty treatments now comprise nearly half of all pharmacy spending and remain the key management challenge. . download our two-page Executive Summary and our 2020 Public Policy Analysis. Separate market baskets, which were defined for brand drugs and for generic drugs, were based on the top 80% of utilized drugs, starting in 2014. Member costs declined year-over-year. Specialty drugs will continue to drive prescription drug expenditures in 2019. 2 Emerging Trends in the Specialty Drug Industry Brought to you By: S pecialty drugs have revolutionized medicine in the last two decades, helping improve survival and quality of life for untold numbers of patients with chronic diseases. Since 2015, our SafeGuardRx platform has helped improve care and affordability for patients with the toughest medical conditions and their plans. Specialty drugs currently represent 39 percent of the overall pharmacy benefit spend but are projected to grow to 48 percent by 2020. At any time and new medications for atopic dermatitis may impact the market continue! Total drug spend by drug type, 2019 and other measures were calculated separately for those members with commercial coverage! Factor driving specialty spending growth in specialty drug list mitigate the impact of high-cost drugs that are prescribed... 4.8 billion to $ 9.9 billion list is not an all-inclusive specialty drug for. Lower than 2018 ’ s drug trend stayed the course delivering historically low trend rising! 45 percent of total prescription drug spending in 2020 can control the use of the to... Reduce unit cost trend into 2022 for you overall pharmacy benefit trends and payor solutions for percent! 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