The Official Medtipster Blog

have your healthcare and afford it, too
Subscribe

Specialty Drug Trend of 18.4% Dwarfs Traditional Drug Trend of -1.5%

March 11, 2013 By: Nadia Category: HealthCare, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Drug Channels, 3/6/2013

Express Scripts just released the latest iteration of its long-running Drug Trend Report. This year’s report includes both Express Scripts and legacy-Medco covered lives, so it’s the most comprehensive look at pricing and utilization.

Study findings

  • Specialty drug trend of 18.4% dominated traditional drug trend of -1.5%.
  • Drug trend for traditional drugs fell to a record-low -1.5%, due largely to the growing substitution of less-expensive generic drugs.
    • Utilization increased by 0.6%, but costs decreased by 2.2%.
  • Drug trend for specialty drugs was 18.4%, consistent with its high growth rate over the past six years.
    • Utilization decreased by 0.4%, while costs increased by 18.7%.
  • Specialty spending is concentrated in a few conditions. For traditional drugs, treatments for the top three conditions of diabetes, high blood cholesterol, and high blood pressure–accounted for 30% of total per-member, per year (PMPY) spend.
  • For specialty drugs, treatments for the top three conditions–inflammatory conditions, multiple sclerosis, and cancer–accounted for 58% of total PMPY spend.
  • Trend reflects two primary components
    • Change in Utilization (the total quantity of drugs obtained by plan members)–Utilization varies with changes in the number of plan members on drug therapy, the degree to which plan members are adherent to their drug therapy, and a change in the average number of days of treatment.
    • Change in Unit Costs–Unit costs vary with:
      • 1) the rate of inflation in brand-name drugs prices,
      • 2) shifts to different drug options within a therapeutic class,
      • 3) a shift in mix of therapeutic classes utilized by plan members, or
      • 4) the substitution of generic drugs for brand-name drugs.

 

Five Largest PBMs

September 26, 2011 By: Nadia Category: HealthCare, Medtipster, Prescription News

www.Medtipster.com Source: Mallory Gillikin, 9/20/2011, www.BusinessInsurance.com

Business Insurance released its ranking of the nation’s largest pharmacy benefit managers. 

  1. Medco - Franklin Lakes, N.J.-based firm reported $66 billion in unbundled PBM revenues in 2010, a 10.4% increase from 2009
  2. CVS Caremark Corp.  – Woonsocket, R.I.-based firm retained the No. 2 position in the 2011 ranking, reporting $47.8 billion in unbundled PBM revenues in 2010, a 6.4% decrease from 2009.
  3. Express Scripts Inc. – Reporting nearly $45 billion in unbundled PBM revenues in 2010, St. Louis-based  firm remained in the No. 3 position in this year’s Business Insurance ranking. Express Scripts, which acquired WellPoint Inc.’s NextRx subsidiaries in December 2009, reported an 81.7% increase in unbundled PBM revenues in 2010.
  4.  Prescription Solutions Inc. - Irvine, Calif.-based firm and
  5. Catalyst Rx - Rockville, M.D.-based firm rounded out the top five largest PBMs.

To view the full ranking or to purchase copies of the 2011 Directory of Largest Pharmacy Benefit Managers, go to www.BusinessInsurance.com/directories.

Get Adobe Flash playerPlugin by wpburn.com wordpress themes