For heart drugs, greater generic penetration

Medco predicts in its 2010 Drug Trend Report that over the next three years, medications in 6 of 16 broad categories will account for about 72 percent of drug cost and utilization.

Leading the way will be agents in the central nervous system and endocrine and diabetes categories, which when combined will account for 40 percent of the spending growth.

Of interest is the cardiovascular category. Compared to last year’s report, the current report suggests that the cardiovascular drugs’ category will see a significant change in share of drug spending and drug costs.

The report says that this category will amount to a large share of total drug costs this year but it will be a less significant contributor to drug costs over the next three years — just 7 percent of total projected drug costs.

That’s because Medco expects a greater effect of generic drugs in the cardiovascular class — in particular the report cites the patent expiration of Lipitor and arrival of several new generics in the angiotensin II receptor blocking class.

Generic drugs have helped moderate the growth of spending on cardiovascular drugs in the past. For example, lipid-lowering drugs had a drug cost of 0.9 percent last year, compared to the total drug cost. When generic versions of Pravachol and Zocor became available in 2006, costs for cardiovascular agents dropped the following two years — 8.5 percent in 2007 and 3.4 percent in 2008.

In 2007’s report, cardiovascular agents were expected to contribute about 24 percent of overall pharmacy spending growth between 2007 and 2009.

The current predictions are based on utilization and cost data collected from 2007-2009 for employers with integrated retail and mail-order benefits.

The average monthly enrollment in the data sample was over 40 million members. This year’s projections include members who enrolled in Medicare Part D plans.

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