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Seven Therapeutic Categories Account for Most Drug Cost Increases

MANAGED CARE December 2011. © MediMedia USA
Managed Care Outlook

Seven Therapeutic Categories Account for Most Drug Cost Increases

MANAGED CARE December 2011. ©MediMedia USA

Over the next three years, more than 80 percent of drug costs will be concentrated in seven therapeutic categories, according to Medco Health Solutions.

However, drugs for the central nervous system and endocrine/diabetes drugs will account for almost 40 percent of spending growth.

“Pharmacy directors at health insurance plans can develop more effective plan strategies by utilizing management tools that can help to improve adherence while controlling overall health care costs, especially in the high trending areas of specialty drugs and chronic disease,” says Glen Stettin, MD, Medco’s chief medical officer.

Cardiovascular treatment consumes a large share of total drug spending, about 22 percent, but marketing developments are expected to slow increases, and cardiovascular drug spending is expected to account for only 11 percent of overall drug spending from now until 2013.

Existing generics as well as “patent expirations for Lipitor [which expired in November] in the cholesterol-lowering class and Plavix [expected to expire in May] in the antiplatelet class and several new generics in the angiotensin II receptor blocker (ARB) class will contribute to this shifting pattern,” the pharmacy benefit company notes in its Drug Trend Report.

Researchers also point out that “the high cost for new anticoagulant drugs and utilization increases for cholesterol-lowering drugs will be responsible for most of the [increase] in the cardiovascular category.”

The report cites predictions by the Centers for Medicare & Medicaid Services that the average annual increase in national drug expenditures will be about 6.3 percent through 2019.

Stettin says that “while there are factors that will continue to drive drug spending upward for a number of major disease categories, taking full advantage of generic versions of blockbuster medications that are entering the market over the next few months will help mitigate some of those rising costs.”

Drug cost increases, 2011–2013. Each category’s percentage of total projected increase in plan ingredient cost

Source: Medco, Drug Trend Report 2011