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Specialty drug trend in 2021
largely recovered from the hit it took from the COVID-19 pandemic in 2020,
driven mainly by an increase in utilization. That’s according to the 2022 Artemetrx
State of Specialty Spend and Trend Report from Pharmaceutical
Strategies Group (PSG), an EPIC company. Published in August, the report is
sponsored by specialty pharmacy Reliance Rx. Findings are based on an
Artemetrx analysis of 73.9 million medical claims and 55.1 million pharmacy
claims from PSG’s book of business.
Utilization is driving
specialty trend
- From 2019 to
2020, specialty trend slowed to 11.8%, down from 12.8% the prior year,
but from 2020 to 2021, it rose to 14.2%. That’s one of the top findings
from the report, according to a PSG/Artemetrx team.
- The report’s
“most notable finding was that trend returned to pre-pandemic rates,”
the team tells AIS Health. “While this was not necessarily a surprise,
it was difficult for anyone to predict when trend would return.”
- Of the overall
specialty trend, 9.4% of it was due to an increase in claim utilization,
with the remaining 4.4% attributed to cost-per-claim changes. “This data
suggests that more people are using specialty drugs, which are getting
increasingly expensive,” observes the team. “When we started the report
six years ago, cost per claim was the primary driver of trend. Whereas
this year claims utilization is the primary driver of trend.”
- The rise in
utilization, says the report, is due to new users of specialty drugs as
opposed to an increase in use among people already taking them. In 2021,
5.5% of the population used at least one specialty drug, up from 4.9% in
both 2019 and 2020.
Biosimilars continue to
gain market share
- In addition,
biosimilar use rose from 12.4% in 2020 to 22.5% in 2021. Biosimilars of
Neupogen (filgrastim) — Zarxio (filgrastim-sndz) and Nivestym
(filgrastim-aafi) — had the most market share, at 76.1%, up from 74.0%
in 2020 and 70.2% in 2019.
- Semglee and
Semglee Pen, biosimilars of insulin glargines Lantus and Lantus
Solostar, had the least market share, at 0.1%, but the biosimilars
launched toward the end of 2021, on Nov. 16.
- The next-lowest
market share was for biosimilars of Remicade (infliximab), at 22.6%, up
from 16.9% in 2020 and 10.0% in 2019. However, the report shows that
since January 2018, the average sales price per unit for both the
reference drug and its biosimilars has continued to decline.
- “The data shows
that the uptake of biosimilars continues to increase across our book of
business year over year,” says the team. “But more importantly, our data
show that the presence of biosimilars continues to drive down the cost
of all drugs in the market basket.”
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