IngenioRx, the PBM being developed by Anthem, Inc., released a drug trend report on May 31 that illustrates how it plans to stand out in a rapidly changing PBM landscape: by analyzing and managing the cost of drugs prescribed to consumers through both their medical and pharmacy benefits, AIS Health reported.
"That’s a key differential in our report that you're not going to see anywhere else, and the numbers aren't going to match up and compare, because those competitors aren’t considering medical drug spend," says Colleen Haines, Anthem's president of clinical and specialty pharmacy.
The report says Anthem's ability to manage both medical and pharmacy benefits kept the average drug cost increase at 2% for the insurer's affiliated employer-based health plans in 14 states in 2017. However, drug trend would have increased by 6% without the comprehensive management, according to the report.
The IngenioRx/Anthem report also analyzes how new drugs are affecting spending. It says the effect of new drugs entering the market drove up the drug trend by 1.2% in 2018, many of which were high-cost specialty drugs.
Among other findings:
- Inflation was the primary contributor to 2017 drug trends, pushing it up by 5.6%.
- Taken together, specialty medical (21.1%) and specialty pharmacy (29.1%) accounted for 50.2% of drug spending in 2017, but by 2021 that share is expected to increase to 59.3%.
- Fifteen commonly treated conditions, including cancer, inflammatory/autoimmune conditions and diabetes, comprised 68% of total drug spending.
- Total non-specialty drug trend decreased by 4.6% in 2017, while total specialty trend increased by 9.9%.
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