- Spending on prescription drugs by commercial insurance plans that work with Express Script Holding Co. rose just 1.5% on a per-person basis in 2017, marking the lowest increase tracked by the pharmacy benefit manager (PBM) in 24 years.
- The upward tick in spending is less than half what Express Scripts recorded in 2016. Lower spending on traditional drugs, such as statins, helped rein in rising drug costs overall, but were counterbalanced by higher prices and utilization of specialty medicines.
- Express Scripts touted the data, which it issued Tuesday in its annual drug trend report, as evidence of its ability to help plans save money on prescription drugs. PBMs, including Express Scripts, have battled with the pharma industry in recent years over who's to blame for high drug costs.
PBMs and the pharma industry have spent the last two years doing their best to blame the other side for rising drug costs. As scrutiny on drug costs has risen, so too has the rhetoric between the opposing groups.
A report released by drug industry lobby PhRMA last fall accused PBMs of pocketing the savings they secure from drugmaker rebates and discounts, rather than passing that money on to insurers and consumers. Fittingly, the group titled its report "Follow the Dollar."
Express Scripts, which is one the three largest PBMs in the U.S., sees things a different way. The company believes the data in its report demonstrate its ability to blunt the impact of rising costs.
Nearly 45% of commercial plans that contract with Express Scripts saw lower drug spending per beneficiary last year, the PBM said. All told, Express Scripts-administered plans cover over 34 million members in the U.S.
Broadly speaking, the patterns in drug spending highlighted in the report can be split into diverging trends. For traditional drugs — which account for nearly 60% of all spending — lower unit costs drove spending down 4.3% last year.
But spending on specialty medicines climbed by 11.3% in 2017, boosted by an 8% jump in utilization and a 3% increase in unit costs. Entry of generic copies to Novartis AG's cancer blockbuster Gleevec (imatinib) and Teva Pharmaceutical Industries Ltd.'s Copaxone (glatiramer acetate) helped ameliorate the rise in specialty medicine unit costs.
It's worth noting, however, that the 11.3% figure is the lowest increase recorded by Express Scripts since it began tracking the data. The PBM has rolled out several initiatives designed to check higher spending on drugs for inflammatory conditions, diabetes, cancer and multiple sclerosis.
In 2017, Express Scripts claims those "solutions" saved plans it represents $340 million.
Data showing slowing price increases — wherever its provenance — makes for strange bedfellows. Jim Greenwood, president and CEO of the biotech industry trade group BIO, quickly seized on Express Script's findings:
Evidence continues to emerge that concern about rising drug spending is overblown. Encouraging new @ExpressScripts data confirms total drug spending for 2017 saw the smallest increase in nearly 25 years https://t.co/N80tvbWFjg— Jim Greenwood (@JimGreenwood) February 7, 2018
Other research paints a different picture, one that Express Scripts would likely point to as what it aims to protect its members from. A recent analysis from the Health Care Cost Institute, for example, found prescription drug prices rose by 25% between 2012 and 2016.