Prime Therapeutics’ Clients See Only 2.5% Drug Spend Increase in 2016

Pharmacy benefits managers (PBMs) served notice last week that they refuse to be labeled as bad guys because of soaring drug costs. Prime Therapeutics today served notice that it wants to go even further: They’re the good guys.

The PBM announced that it held the overall drug spending increase to just 2.5% last year. But every silver lining has its cloud, which the Prime Therapeutics’ data illustrates. The PBM managed to hold spending on traditional drugs to just 1.7% last year. But everyone’s eye is on specialty drugs, and Prime Therapeutics said that increase came in at 13.7% for its 20 million members. The total financial savings to clients was more than $2.2 billion, according to the PBM’s data.

Two categories largely fueled the increase. The increase for the non-specialty drugs for diabetes came in at 13% of the total pharmacy spend. Specialty drugs for rheumatoid arthritis also soared; the increase for them coming in at 12% of the total expenditures in the pharmacy benefit.

The PBM says that its management of generics led to an increase in utilization from 83.1 to 84.7% in 2016. “This is significant as generics are considerably less expensive than brand-name drugs and are also one of the best ways members can save money,” the company said in a press release. “Additionally, Prime optimized generic pricing, which resulted in a 5 percent reduction in the average cost per generic prescription.”

Source: Prime Therapeutics(link is external)