Prescription Drug Spending in 2012

Jane Sarasohn-Kahn

Posted 11/3/11 on Health Populi

growth in prescription drug costs covered by employers and Rx plan sponsors are driving them to adopt a long list of utilization management and price-tiering strategies looking to 2012, according to the 2011-2012 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals.

The average drug trend for 2011 — that is, the average annual percentage increase in drug cost spending — was 5.5%, 1.5 percentage points greater than general price inflation of about 4%. The generic fill rate was 73% of prescription drugs purchased at retail. While drug price inflation is expected to increase in 2012, plan sponsors will implement several programs targeting enrollees who are most responsible for high cost and volume Rx consumption; the most popular programs will be disease management (to be used by 62% of plan sponsors), therapeutic substitution (50%), and outbound telephone calls (42%), retrospective drug utilization review (DUR, 40%), and face-to-face pharmacist consults (39%). Disease management and retrospective DUR both fell in use since 2010. Utilization management programs are also commonly integrated into prescription drug plan designs, with the most common tactics being prior authorization, quantity limits, and limits on “refills-too-soon.” Step therapy, too, is growing in use, particularly for medications treating depression, asthma, high cholesterol, and high blood pressure.

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Specialty Drugs Will Drive Future Rx Spending Trend

Jane Sarasohn-Kahn

First published 5/19/11 on Health Populi

In the 2011 Medco Drug Trend Report, there’s good news and bad news depending on the lens you wear as a health care stakeholder in the U.S. On the positive side of the ledger, for consumers, payers and health plan sponsors, drug trend in 2010 stayed fairly flat at 3.7% growth. That’s due in major part to the increasing roster of generic drugs taking the place of aging branded prescriptions products. More than $100 billion (with a ‘b’) worth of branded drugs will go off-patent between 2010 and 2020, and the generic dispensing rate could reach 85% by 2020, Medco expects, especially looking at high-cost categories like statins. So generics are dramatically slowing drug cost increases overall.

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