Express Scripts: Drug spend grew 5.8% in 2015

ST. LOUIS — Express Scripts announced this week that it had slowed prescription drug spending growth to 5.3% in 2015, which it attributes to the adoption by clients of the company’s cost-saving solutions and specialized pharmacy care. Specialty spending rose 17.8% in 2015.

 

Express Scripts said that clients who used four or more of the company’s cost-saving plans contained their drug spend increase to about 3.3%, which would have saved $6 billion if all plan sponsors in the United States had adopted similar programs. Some clients, the company said, even saw their spending hold or decrease, with member out-of-pocket expenses per monthly prescription dropping 3.2%. 

 

“Standing with payers and patients, Express Scripts controlled costs, expanded access and improved care through the use of our cost-saving, clinically focused solutions,” Express Scripts chief innovation officer Dr. Glen Stettin said. “Our clients collaborated with us to confront significant challenges to affordable care in 2015 – including a record number of newly approved, high-cost therapies and new drivers of spend and waste – to maintain an affordable benefit for patients. In addition, our pioneering efforts to protect clients from brand inflation are mitigating the effect of drug price hikes on patients and their plans.”

 

Part of the savings came from Express Scripts’ National Preferred Formulary, which it says has saved clients enrolled since 2014 $3 billion. The company also points to its Hepatitis Cure Value Program for saving clients money in the specialty category — which is projected to make up 50% of spending by 2018. It saved payers about $1 billion on curative hepatitis C treatments, a cost decrease of 50%. Additionally, the company’s Accredo specialty pharmacy saw persistence rates of 93% to 94% for Viekira Pak and Harvoni — many other specialty and retail pharmacies saw persistence rates of 83% to 92%

 

And though Express Scripts said it has managed costs associated with specialty, it continues to be a big driver of spending, which increased 17.8% on specialty in 2015. Besides specialty, the average price for branded drugs rose 16.2% in 2015, with a third of branded product seeing a price hike last year. 

 

“Drugmaker consolidation, price hikes ahead of impending patent expirations and hyperinflation on older medications without therapy class competition all contributed significantly to increased drug spending,” Stettin said. “Fortunately, payers who closely manage their benefit soon can leverage the generic availability of specialty medications like Gleevec (imatinib) — which experienced a three-fold price increase over the past 10 years before it lost patent protection last month —and also tap into the potential $39.7 billion in savings from biosimilars over the next five years.”