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Rising Specialty Drug Costs Worry Nonprofit Health Plans

Marketplace about to explode as more high-cost, handle-with-care drugs come online, group warns
 

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October 20, 2014—While specialty drugs account for less than 1 percent of all U.S. prescriptions, they accounted for more than 25 percent of the country’s total pharmacy costs last year, the Alliance of Community Health Plans notes in a new issue brief.

ACHP recently held briefing on Capitol Hill to discuss its findings and to offer perspectives on escalating specialty drug costs from key stakeholders. “The specialty drug marketplace is about to explode with much higher [spending] increases in the coming years, as more high-cost specialty drugs enter the market,” ACHP said in its report. In 2013, it said, spending on specialty drugs to treat cancer, multiple sclerosis, and rheumatoid arthritis cost $6.9 billion, or 68 percent of the total growth in drug spending. Spending on all specialty drugs is expected to increase by 361 percent from 2012 to 2020, going from $87 billion to $402 billion, noted Bobby Clark of PwC Health Research Institute, one of four experts who spoke at the briefing.

Source: PwC Health Research Institute, http://pwc.com/us/medicalcosttrend
Source: PwC Health Research Institute

Rising drug costs are translating into higher out-of-pocket costs for employees, Clark added. This year, 34 percent of employers are saying they will use copays greater than $60 for specialty drugs, which has grown by 229 percent since 2010, he said.

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