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Pharmacy Trends for 2013 and Beyond

May 29, 2013 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

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As pharmacy trends shift and costs for plan sponsors increase, we continue to maintain a panoramic view of the industry to control medication spend for our clients. By keeping plan sponsors informed of these shifts and our strategies for handling them, plan sponsors are empowered to make informed choices about their pharmacy benefit plans. In the spirit of our transparent business approach, following are some key trends we foresee occurring in this marketplace.

Generics Plateau

In 2012, new generics entering the market reached record highs, with more than 80% market share as two major brand products (Lipitor and Plavix) lost their patents. The product with the fastest growth in 2012 was atorvastatin  – the generic version of Lipitor. The medications were considered blockbuster agents, with more than $1 billion in annual sales before turning generic.

While sales of generics grew, sales of brands decreased. Because of the influx of generic products, 2012 was a marquee year. As such, we expect fewer generics exclusivity periods in coming years, and generics are expected to reach a ceiling where they can no longer surpass their current market saturation.

Growth & Trend by Therapy Class

Therapy classes with the most growth in 2012, based on total scripts dispensed, included:

• Anti-depressants • Seizure disorders • Proton Pump Inhibitors

The top five therapy classes, which accounted for one-third of plan sponsor drug spend, included:

• Oncologics  (used to treat cancer) • Respiratory agents (used to treat asthma and Chronic   Obstructive Pulmonary Disease (COPD)) • Antidiabetics (used to lower elevated blood sugars) • Lipid regulators (used to lower high cholesterol or related   disorders) • Antipsychotics (used to treat schizophrenia and related   disorders)

Trends in Specialty

Less than one percent of the U.S. population uses specialty medications, but these products account for 25% of all pharmacy spend. As you are aware, the staggering costs in this pharmacy channel are not new. The good news is that we hope to see increased competition soon, with 38 specialty products expected to have patent expirations through 2017, and new legislation that will promote competition in this therapeutic space.

At the same time, the FDA has approved many more drugs in recent years that treat oncology and orphan diseases. Orphan drugs are used in treating very rare diseases, known as orphan diseases. Because of the niche market on these products, the cost to produce and sell them is very high. For instance, five of the most recently approved orphan drugs will cost at least $150,000 per patient per year. Costs for these products will only continue to rise, since drug makers and biotechnology companies for these products currently have no competition.

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