policy

Pharmacy/Prescription Drugs

Expenditures for specialty drugs are consistently growing faster than any other component of healthcare spend, faster than the rate of overall health care inflation, and far outpacing that of general inflation and overall economic growth. Moreover, they are projected to overtake traditional pharmaceuticals over the next several years in the number of drug approvals, spending and utilization.

While plan design and utilization management tools can help to drive down spending, policy reforms are needed to foster more sustainable pricing, promote appropriate utilization of high-priced drugs and reduce unnecessary spending. In addition, the federal government can review and revise policies that reduce price competition. Ultimately though, an effective public policy response to the substantial and ever-increasing growth in spending on specialty drugs will require open dialog with all relevant stakeholders to construct market-oriented and consensus-driven strategies.

 

Top RightThis Numbers You Need chart examines how pharmacy costs are projected to increase over the next three years for the most expensive specialty drug therapy classes.

Top RightThis Numbers You Need chart shows a comparison of the prescription drug trend projections for traditional pharmacy vs. specialty pharmacy.

 

 

 

Featured Resources

Policy Recommendations to Promote Sustainable, Affordable Pricing for Specialty Pharmaceuticals Policy Recommendations to Promote Sustainable, Affordable Pricing for Specialty Pharmaceuticals
This policy brief describes the challenges large employers face in managing high-priced specialty drugs, examines ways to better manage them and offers public policy recommendations that would create a more favorable environment for financial sustainability and affordability of these medications.

Biologics Competition: An Update on the Market and Future Policy Actions Biologics Competition: An Update on the Market and Future Policy Actions
Understanding how public policy will impact employers ability to utilize biosimilar drugs in place of high price branded specialty/biologic drugs.

Comments to the FDA Supporting Regulatory Approach to Approval of Biosimilars Comments to the FDA Supporting Regulatory Approach to Approval of Biosimilars
The National Business Group on Health submitted comments to the FDA strongly supporting a regulatory environment which favors the robust uptake of high quality, safe, and efficacious biosimilars.

 

Also of Interest

Specialty Pharmacy Management Series
Ongoing series exploring a range of issues in specialty pharmacy management. These summary documents outline key topics discussed during Specialty Pharmacy Subcommittee calls, sponsored by the National Committee on Pharmacy Benefits and Specialty Medicine (PBSM).

What Your CEO is Reading — Drug Pricing
This newsletter highlights recent articles that report on drug spending in 2015 based on data from the nation's two largest PBMs. Spending increased by approximately 5% in 2015. This increase, while twice the consumer price index (CPI), is significantly less than that of 2014, despite similar price inflation patterns — a sign that aggressive management of prescription drugs by the PBMs is working to help mitigate overall drug spend and to at least temper inflationary forces.

What Your CEO is Reading — Anti-Inflammatory Specialty Drugs
This newsletter highlights a New York Times articles about a new effort to address high-priced anti-inflammatory specialty medications taken by millions of people for conditions such as rheumatoid arthritis, psoriasis and Crohn’s disease. The rising costs associated with these drugs are a result of the increase in the price of these medications and an increase in the number of patients using them.

 

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