Findings from the 2013 Express Scripts Drug Trend Report, released today, reveals better decisions, cost and utilization management programs helped to keep the increase in U.S. spending on specialty medications at 14.1%, the lowest annual increase since 2007. However, this is the calm before the storm, as our country faces a 63% increase in specialty-drug spend between 2014 and 2016, fueled primarily by an unprecedented 1,800% increase in spending on Hepatitis C.
Drug Trend 2006 to 2013
Closer Look at Specialty Spending
While less than one percent of all U.S. prescriptions, specialty medications in 2013 for the first time accounted for more than a quarter (27.7%) of the country’s total pharmacy spend.
Three specialty classes – inflammatory conditions, multiple sclerosis and cancer – accounted for 60% of total specialty spend in 2013.
Treatments for inflammatory conditions, such as rheumatoid arthritis and Crohn’s disease, continue to rank as the costliest specialty therapy class, driven by brand price inflation of 15% in 2013.
The therapy class that saw the largest percentage increase in spending during 2013 (39.2%) was central nervous system disorders, which includes treatments for Huntington’s disease, narcolepsy and Parkinson’s disease.
Components of Trend for the Top 10 Specialty Therapy Classes Ranked By 2013 PMPY Spend
Other major contributors to increased specialty spending from 2014-2016 include:
Trend Forecast Top 12 Specialty Therapy Classes
- Respiratory disorders, which will substantially increase in 2015 and 2016 with game-changing new mediations for cystic fibrosis and idiopathic pulmonary fibrosis (IPF), the latter of which has no available approved therapies in the U.S.
- Central nervous system disorders, which is expected to grow more than 40% each year of our 2014-2016 forecast.
Higher Brand Prices Increase Spend on Traditional Medications
After years of slow growth and despite unprecedented availability of generic medications, spending on traditional prescription drugs – primarily pills taken to treat more common diseases such as high cholesterol and high blood pressure – increased 2.4% in 2013.
A peak at what’s fueling the increase in trend:
- Diabetes was the costliest drug class for the third consecutive year, with an increase in spending of 14% in 2013. Express Scripts forecasts spending on diabetes drugs to continue to see double-digit annual rate increases over the next three years, due to a pipeline of new medications and price inflation among existing brand medications.
- Spending on compounded drugs more than quadrupled in 2013.
- Largely due to the coverage mandate within the Affordable Care Act, cost shifting led payers to spend 30.7 percent more on contraceptives in 2013 than in 2012.
- Spending on anti-infective medications increased 6.2% in 2013, due in part to drug shortages and resulting price increases for doxycycline and tetracycline.
- With increased generic competition, spending in seven key therapy classes – high blood cholesterol, high blood pressure/heart disease, ulcer disease, asthma, depression, mental/neurological disorders and infections – is expected to decline in both 2014 and 2015.
Components of Trend for the Top 10 Traditional Therapy Classes Ranked by 2013 PMPY Spend
Trend Forecast Top 12 Traditional Therapy Classes
View the complete Drug Trend Report online or download the complete 90-page PDF.
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