{"id":83930,"date":"2021-01-29T01:18:20","date_gmt":"2021-01-29T06:18:20","guid":{"rendered":"https:\/\/decisionresourcesgroup.com\/?p=83930"},"modified":"2024-07-05T16:44:58","modified_gmt":"2024-07-05T16:44:58","slug":"2019-pbm-trend-specialty-sector-center-stage","status":"publish","type":"post","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/blog\/2019-pbm-trend-specialty-sector-center-stage\/","title":{"rendered":"2019 PBM trend: Specialty sector at center stage"},"content":{"rendered":"

While big PBMs like ESI and CVS Caremark promote exceptional market control through their 2019 PBM trend reports, Prime Therapeutics failed to effectively control drug price inflation. In line with the trend for slow growth, commercial drug spending grew at an average of three percent. While drug utilization remains the leading cause of increasing specialty drug spend for most PBMs, MedImpact\u2019s cost management strategy has not worked well in 2019.<\/p>\n

Key Takeaways from 2019 Drug Trend Report from top PBMs<\/strong>:<\/strong>\u00a0<\/strong><\/span><\/h2>\n

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COMMERCIAL TREND<\/strong><\/p>\n

As the 2019 PBM spend comes into focus, the year-over-year percentage difference in patient spend continues to be lower single digits and the specialty wave continues to drive most of the change. For all PBMs, specialty drug spending accounted for a greater share of total spend than in 2018. As inflammatory disease therapies expanded in 2019, through label expansion of Stelara and drug approval of Skyrizi, this drug class continues to contribute heavily to spending through value and volume. While higher drug utilization remains the driver of increasing drug spend for most PBMs, Prime Therapeutics and MedImpact report unit cost increases higher than utilization increase.<\/p>\n

SPECIALTY TREND<\/strong><\/p>\n

The average specialty trend was much higher than the total drug trend for all PBMs considered. Utilization increases rather than unit cost surge is attributed to the high specialty trend, at least that is the case with tightly run PBMs. PBM management of specialty drugs will continue to be in the spotlight as that sector continues to shape many industry decisions. Inflammatory drugs top the charts of high-spend specialty drugs and remain a dynamic class with indication expansion, drug approvals, and generic entries.<\/p>\n

TRADITIONAL TREND<\/strong><\/p>\n

Traditional drug spend growth continues to decline as unit price drops and generic dispensing rates remain constant. Cost reduction in pain and inflammatory drug class in 2019 due to generic entry coupled with lower utilization of opioids due to concerns of opioid abuse is causing the traditional category spend to slide down. The diabetic drug class has authorized generics entering the market in 2020. Also, insulins to be deemed biologic might drive the category price up marginally. Drug classes that have spiked in utilization are antipsychotics, antidepressants, and anti-diabetic agents.<\/p>\n

PBM 2020 \u2013 TRENDS TO WATCH<\/strong><\/p>\n