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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.

 

Medtipster Sees Growth In Generic Drug Switches With Co-pay Waivers

December 14, 2010 By: Nadia Category: Free Prescriptions, HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Medtipster Client Data: August 1, 2009 – November 30, 2010

Medtipster.com, working with it’s employer sponsored benefit plan members, found that offering a waiver of generic drug co-payments led to more switches to generics from their brand equivalents and that plan members were more likely to remain on their generic drugs after the switch was made.

The waiver program resulted in savings of about $500,000. to the sponsor and about $750,000. to the plan members during the observation period.

To improve generic dispensing rates, Medtipster offered plan members using brand medications in 40 therapeutic classes up to two co-pay waivers if they switched to a preferred generic drug. Information about the waiver was mailed to plan members, alerting them that all they needed to do was switch within six months of receiving the communication.

Members who took advantage of the waivers early in the six-month period were able to use it twice, while members who acted later in the window were only able to use the waiver once.

The recently enacted health care reform law has a provision in it that will allow Medicare Part D plan sponsors, beginning with the 2011 plan year, to reduce or waive the first co-pay for a generic drug when a plan member switches from its corresponding brand product.

Medtipster examined how many of the plan members remained on the generic drug after receiving one or two co-pay waivers. Findings among the top four therapeutic classes (HMG CoA reductase inhibitors, antihypertensive combinations, proton pump inhibitors and beta blockers cardio-selective) showed that plan members who took advantage of two co-pay waivers had higher generic dispensing rates in the fill immediately after the waivers and had higher sustained GDRs during the months after the generic dispensing conversion program began compared to those only using one waiver.

For example, 94.9 percent of members using beta blockers filled the next prescription with a generic following the use of two waivers, compared to 59.5 percent who used only one waiver. Members who used two waivers had a sustained generic dispensation rate of 89.5 percent, compared to 58.5 percent who only used one waiver.

The drug that showed the highest difference in sustained GDR between the use of two waivers and one waiver was AstraZeneca’s high blood pressure medication Toprol XL (metaprolol succinate), which had sustained GDR of 91.5 percent for members using two waivers, compared to 62.5 percent for members who used only one waiver.

Of the top 10, the drug that had the lowest difference was AstraZeneca’s cholesterol lowering drug Crestor (rosuvastatin), which had a sustained GDR of 82.7 percent for members using two waivers versus 78.1 percent for members who used one waiver.

Generic Drug Prices Drop, Brand Prices Continue Rising

May 25, 2010 By: Nadia Category: HealthCare, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: FDAnews.com – Washington Drug Letter, 5.25.2010

AARP: Generic Drug Prices Drop, Brand Prices Continue Rising

The prices of brand-name prescription drugs most often used by Medicare beneficiaries increased nearly 10 percent over the 12-month period ending in March, an AARP report says.

While generic drug prices fell during the April 2009 to March 2010 period, the average price of top brand drugs used by Medicare beneficiaries rose 9.7 percent, continuing an upward trend in annual drug price increases, according to the AARP Public Policy Institute Rx Watchdog Report released last week.

Prices of generic drugs most widely used by Medicare beneficiaries dropped 9.7 percent while prices for widely used specialty drugs rose by 9.2 percent.
“These trends resulted in an average annual rate of increase of 5.3 percent for manufacturer drug prices during the 12 months ending with the first quarter of 2010 despite an extremely low rate of general inflation for all consumer goods and services,” the report says.

Drug companies raised the price of about two-thirds (90 of 144) of specialty drugs studied in the one-year period. Two of the 144 specialty drugs had a drop in price, and both were generics. For an individual taking one specialty medication, the average annual increase in cost of therapy rose by $2,760 during the study period.

AARP’s analysis echoes that of pharmacy benefit managerExpress Scripts’ 2009 Drug Trend Report, released last month. Prices of drugs in the most popular therapeutic classes increased 9.1 percent in 2009, according to that report.

PhRMA, however, said the AARP report is misleading and based on incomplete information. The report fails to take into account discounts and rebates generally negotiated between drug manufacturers and payers, which can significantly lower the cost of brand-name medicines, ultimately benefiting patients, Senior Vice President Ken Johnson said.

“Also, the report’s conclusions ignore the reality that prescription medicines represent a small and decreasing share of growth in overall health care costs in the United States,” Johnson said. “Not only is the current rate of growth for prescription medicines historically low, but the recent decline in drug spending growth has contributed to the lowest rate of total health care growth in almost 50 years.”

Employers to Encourage Generic Medications

April 16, 2010 By: Nadia Category: Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Managed HealthCare Executive, April 16, 2010

Survey: employers to encourage generic medications

CVS Caremark has announced the results of its annual employer client benefit survey about priorities for pharmacy benefit management (PBM) services in the coming year. The majority of employers surveyed (94%) said they will seek opportunities to improve savings even more in 2010, while they look for ways to improve the overall member experience. Employers listed price (86%), customer service (86%), trust and reliability (84%) and consumer engagement capabilities (46%) as key priorities for their PBM procurement strategy.

The economic environment continues to impact companies, with 66% of respondents answering that reducing overall healthcare costs is their No. 1 success measure, says Jack Bruner, executive vice president, Strategic Development, CVS Caremark Pharmacy Services.

Survey results show that the majority of employer clients are strongly considering adopting some of the more progressive strategies to encourage the use of lower-cost generic medications. For example, almost half of employers surveyed are considering implementing plan designs that require using a generic medication first before moving to a branded drug (50%) and those that provide members a co-pay waiver to switch to generic medications (56%).

“For our book of business, approximately 35% of brand-spend medications have a generic opportunity,” says Bruner. “Our strategy is to focus on specific therapeutic classes (e.g., proton pump inhibitors, HMG reductase inhibitors, angiotensin II receptor blockers, hypnotic sleep aids, migraine agents, nasal steroids, non-sedating antihistamines, selective serotonin reuptake inhibitors, etc.) where ample generics are available.

According to the survey, a majority of employer clients (88%) and health plan clients (97%) are taking an aggressive or moderate approach toward maximizing generic dispensing in key therapeutic classes as a strategy to increase savings opportunities.

Through 2012, nearly 30 brand-name medications in a variety of classes are expected to become available as generics, including some popular drugs such as Lipitor for treating high cholesterol, according to Bruner.

“We anticipate this will have an impact on opportunities for increasing generic dispensing rate for our clients, resulting in increases savings for clients and their members,” he says.

Bruner expects the rate of employees actually taking advantage of generic substitution/lower-cost alternatives to vary depending on the type of intervention program that is implemented.

“For example, if a client adopts a mandatory generic use program such as step therapy, we see greater than 80% brand to generic substitution/conversion within a therapeutic class,” he says. “If the client implements a generic co-pay waiver to incent brand users to switch to generics, the behavior change rate is less than 10%. However, when a pharmacist counsels a patient at retail or mail about a generic opportunity, the conversion rate is over 30%.”

Compared to the 2009 survey results, the survey found there has been an increase in employers who are adopting or considering solutions to improve medication adherence. In particular, many employer clients are considering programs that impact adherence through counseling and intervention with the member, including: counseling to improve adherence the first time a member fills a maintenance medication (62%), outreach to prescribers to resolve gaps in care (56%) and outreach to members and prescribers to provide counsel about therapy drop-off (65%).

The CVS Caremark client survey was conducted online from Oct. 5, 2009 through Dec. 31, 2009 and includes responses from current CVS Caremark clients representing 285 employers.

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