Traditional drug spending falls, specialty spending rises, ESI report finds

ST. LOUIS — Price inflation for the most commonly used branded drugs has been more than six times that of overall inflation for consumer goods since September 2011, according to a new report by pharmacy benefit manager Express Scripts.

The PBM released its first drug-trend quarterly, showing that the price gap between branded and generic drugs widened by 35.2% between September 2011 and September 2012, while year-to-date spending on specialty drugs increased 22.6%. The report reviews year-to-date and quarter-over-quarter changes in national drug spending for all major therapy classes.

"The patent cliff has fueled a growing price disparity between brand-name and generic medications," Express Scripts chief medical officer Steve Miller said. "The trend emphasizes the nation's continued need for the tools we employ to help patients make better decisions, including generic use when appropriate."

Overall, lower prices brought on by increased use of generic drugs resulted in a 0.6% decrease in spending on traditional medications. Among these, total spending on cholesterol and high blood pressure drugs decreased by 7.7%; drugs for mental and neurological disorders are the top traditional therapy class, consuming 24.7% of all traditional drug spend, but while use of these drugs has increased by 3.1% compared with the first three quarters of 2011, total spending is down by 1.9% due to availability of generics.

At the same time, spending on specialty drugs increased by 22.6%, consuming 20.8% of total pharmacy spending in the first nine months of 2012, with drugs for autoimmune conditions, multiple sclerosis and cancer constituting the top classes in terms of spending.

"The continued rise in spend on specialty medications underscores the nations need to accelerate the pathway for biosimilars," Miller said, referring to knock-off versions of biotech drugs. "Additional competitions within these therapy classes would provide a necessary market control against price inflation."

Drugs for hepatitis C have had the largest increase in spending, going up by 117.3% over the first three quarters of 2011.

The report also highlighted obesity drugs. "The potential benefits of these new anti-obesity medications need to be compared against their risks and cost," Miller said. "We are cautiously optimistic about the possibilities of these and other drugs like that, provided that they are prescribed appropriately and integrated with other lifestyle modifying programs that help patients make healthier choices that maintain their weight over time."

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