by Robert King | Aug 21, 2019 2:42pm
A major
employer purchasing group devoted 40% of its total drug spending in 2018 to
drugs prescribed to less than 1% of its members. Image: Eric Palmer
Specialty drugs for treatments such as arthritis accounted for
less than 1% of prescriptions for a major employer purchasing group but made up
40% of the group’s total drug spending last year, according to a new analysis.
The analysis from Willis Towers Watson’s Rx Collaborative, a
large employer pharmacy benefit group purchasing organization, underscores a
major problem the rest of the healthcare industry is facing in trying to find
ways to pay for a select few pricey medications.
The top three drugs that cost the most for Willis Towers were
injectable immunotherapy drugs indicated for psoriatic arthritis, rheumatoid
arthritis and Crohn’s disease. The collaborative, which has roughly 5 million
customers and includes more than 400 employers, detailed several ways it
tried to rein in drug spending on specialty products.
“In 2018, we successfully
collaborated with payers to develop weekly reporting that flagged high-cost
specialty claims for secondary review, which further controls spend,” said
Nadina Rosier, head of the pharmacy practice for Willis Towers, in a statement.
Costs for certain non-specialty drugs also rose. Insulin’s cost
per prescription increased by about 4% in 2018. Specialty drug costs have
become a major cost headache for other payers too, including Medicare Part D.
Net spending on specialty drugs rose from $8.7 billion in 2010
to $32.8 billion in 2015 on Part D, according to a report from the Congressional Budget Office.
Plans and payers have looked for strategies to curb the costs of
such specialty drugs, including employing formulary management tools such as
step therapy that require a patient to try a cheaper drug before moving on to a
more expensive one.
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