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Pharmacy

Prescription Drug Benefit Cost Trend

After a ten year decline in prescription drug trend, pharmacy costs are now on a three year rise. Prescription drug trend now outpaces medical trend overall.

For more information on this chart, please see Mercer's National Survey of Employer-Sponsored Health Plans report.

Specialty Pharmacy Costs Continue to Increase at Unsustainable Pace

While the costs of traditional pharmaceuticals are increasing at a very low rate over the last few years, the spiraling costs of specialty pharmaceuticals promises to offset any potential savings.

For more information on this chart, please see the Express Scripts’ Drug Trend Report.

Employers’ Use of Management Techniques for Pharmacy Benefits

Employers use a number of techniques to manage traditional pharmacy costs. The most common methods include: prior authorization, step therapy quantity limits, and members pay the difference between brand and generic medications.

For more information on this chart, please see the National Business Group on Health's Large Employers' 2017 Health Plan Design Survey report.

Contributions to Net Plan Specialty Costs by Category

The majority of specialty pharmacy costs cover a few key conditions, such as inflammatory conditions, multiple sclerosis, oncology and Hepatitis C.

For more information on this chart, please see the Express Scripts’ Drug Trend Report.

 

Employers’ Use of Management Tactics for Specialty Pharmacy Benefits

Employers rising costs of specialty pharmaceuticals as top driver of medical trend. As a result, employers are increasingly looking at new ways to ensure appropriate use and control costs of specialty pharmaceuticals.

For more information on this chart, please see National Business Group on Health's Large Employers' 2017 Health Plan Design Survey report.

Specialty Pharmacy Costs, by Therapy Class

Specialty medications are expected to increase by double digits each year, but the trend is being driven by a few therapy classes of drugs.

For more information on this chart, please see the Express Scripts’ Drug Trend Report.

Cost of Top Workers’ Compensation Medications

Like medications overall, the costs of medications that are commonly used to treat employees on workers' compensation are on the rise. The increase in spend is due to a combination in the increase of the per script cost and an increase in utilization.

For more information on this chart, please see the Express Scripts’ Workers' Compensation Drug Trend Report.

Specialty Drug Approvals and Sales

The number of specialty drugs being approved each year is skyrocketing. And with the estimated sales of some of the drugs coming down the pipeline, specialty drug spend is likely to continue to increase

For more information on this chart, please see PricewaterhouseCoopers’ Medical Cost Trend: Behind the numbers 2015 report.

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