WOONSOCKET – Spending on prescription drugs rose 4 percent last year, as more patients were prescribed specialty medications and took advantage of prescription benefits from their health insurance programs in an improving economy, CVS Caremark Corp. said Thursday in its annual Insights report.
After spending remained nearly flat in 2012, prescription drug expenditures climbed 3.8 percent last year, due largely to a 15.6 percent increase in specialty medication spending nationwide. Specialty drugs, used to treat diseases such as cancer, now make up 22.4 percent of all drug spending among the chain’s health-plan and employer clients, CVS said.
Use of generic drugs, meanwhile, reached their highest levels since CVS began tracking them, with the so-called generic dispensing rate, or GDR, reaching 81.4 percent.
There are fewer generic drugs in the pipeline going forward – the value of drugs to come out of patent protection in 2013 was just half of the $35 billion estimated for 2012 – but there remains room for more growth as additional insurers and providers embrace generics over name-brand drugs, according to the report.
CVS’ annual report captures trends in spending per member per month. The study drew its data from 22.9 million members in health plans as well as those on Medicare and Medicaid.
Jon Roberts, president of CVS Caremark’s pharmacy benefit management business, said several key trends in the report have implications for the health care industry, including the high-water mark for generics, the power of specialty drugs to push prices higher and the fact that “price is king,” and “money matters to members.”
“This is not just a catchy list of factors that impact drug trend,” Roberts said in a release. “These are key concepts for our clients to consider when determining how to maximize their prescription drug benefit in the complex and changing health care landscape.”
The report makes suggestions for how organizations can save money while also improving the health of their patients, including using more generic formulation, transitioning the cost of specialty medications to a plan’s pharmacy benefit from its medical expenditure category and narrowing the size of pharmacy networks.
CVS also recommend health plans take a strategic approach to managing cost shares with patients, noting that how much members pay themselves will affect where and even if they will fill prescriptions and citing a survey suggesting that one out of every three patients will not fill a prescription if they deem the cost to be too high.
CVS also emphasized the value of wellness programs and preventive medicine to help avoid the need for expensive prescriptions.