For the first time in more than 20 years, there was a decrease in 2012 U.S. spending on traditional prescription drugs — primarily pills people take to treat more common diseases such as high cholesterol and high blood pressure — according to new data released today by Express Scripts (NASDAQ: ESRX).
Among the country's commercially insured population, total spending on traditional prescription drugs fell 1.5 percent in 2012. However, this decline was offset by an 18.4 percent increase in spending on specialty medications to treat more complex diseases such as rheumatoid arthritis, cancer and hepatitis C. Combined, total drug trend for the year was +2.7 percent, consistent with the rate of growth in 2011.
The Express Scripts 2012 Drug Trend Report quantifies annual changes in utilization, unit costs and overall prescription drug spending, based on Express Scripts claims data. Now an online publication, the full report is available at www.DrugTrendReport.com.
"The first-ever decrease in traditional drug spending is the latest chapter of an ongoing success story for our utilization management programs and for an increased interest in generic medications, home delivery pharmacy and more focused retail pharmacy networks," said Glen Stettin , MD, Express Scripts senior vice president of Clinical, Research & New Solutions.
"These same principles of effective management solutions and increased drug competition are necessary to the country's effort to rein in specialty drug costs," Stettin said. "The plan sponsors who implement our specialty management programs are already seeing much lower growth in specialty drug costs than the national average. And increased drug competition, in the form of biosimilars, is necessary to offer more affordable medication for patients afflicted with these complex specialty conditions."
A Historic First in Traditional Prescription Drug Spending
Since 1993 when Express Scripts began recording annual drug trend, 2012 marks the first year where total spending on traditional drugs declined.
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Last year's "patent cliff" ushered in lower-cost generic alternatives for many blockbuster medications and utilization increased for eight of the top 10 traditional therapy classes, while unit costs decreased in seven.
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For the second consecutive year, the country spent more on prescription drugs for diabetes than for any other therapy class. Diabetes drug spending increased 11 percent in 2012, driven in part by unit cost increases for popular insulins.
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Spending on medications to treat attention disorders increased 14.2 percent in 2012. Utilization increased 8.8 percent, due largely to an increased number of adult patients. Unit costs increased 5.4 percent as a result of a 2012 shortage of active ingredients contained in many of the medications in this class.
The Increasing Challenge of Specialty Prescription Drug Spending
Specialty medications often require specialized handling or administration, frequent dosing adjustments, and intensive clinical monitoring and patient assistance. While affecting fewer than 2 percent of the general population, specialty conditions in 2012 accounted for 24.5 percent of the country's total drug spend within the pharmacy benefit, the highest percentage on record.