The results of a recent study undertaken by Express Scripts, a provider of integrated pharmacy benefit management services in the United States, found that average brand-name prescription drug prices in the United States has risen by 98.2% since 2011.
In 2015, brand-name prescription drug prices rose 16.2% on average, and one-third of the branded products had price increases greater than 20% in 2015. In 2014, prescription drug spending in the United States had increased at its highest rate since 2003, largely due to spending on Hepatitis C treatment drugs. In 2015, drug spending in the United States increased 5.2%, which was half the rate in 2014.
Total drug spending is forecast to increase between 6% and 8% annually in the United States between 2016 and 2018. Specialty medication spending, led by inflammatory conditions and new discoveries for cancer, is forecast to increase an average of 17% annually over the next three years.
Specialty medications accounted for 37% of U.S. drug spending in 2015, despite being used by only 1% to 2% of the population; specialty medications are projected to reach 50% by 2018. Spending on specialty medications increased 17.8% in 2015, and is expected to increase steadily an average of 13.6% over the next three years. For 2015, a specialty disease class (inflammatory conditions, which includes rheumatoid arthritis) was the costliest overall drug category. Spending on medications for inflammatory conditions, multiple sclerosis, and oncology represented 56.3% of the spending in the United States on specialty medications.
Express Scripts found that three of the top five traditional drugs in total spending were diabetes medications; spending on ADHD medications increased 8.5%, largely due to increased utilization; the unit cost for medication to treat skin conditions increased 26.4% in 2015, due to drug maker consolidation; and, the top five most prescribed multiple sclerosis medications accounted for 84% of spending in this class.
Medicare Drug Spending
Medicare traditional trend was 4.8% in 2015, after accounting for rebates. Traditional drug trend is anticipated to increase by an average of 8.9% over the next three years. Four of the top ten traditional therapy classes – mental/neurological disorders, high blood cholesterol, high blood pressure/heart disease, and heartburn/ulcer disease – are forecast to continue with negative trends all three years, due to declines in unit cost resulting from patent expirations and greater generic dispensing. The largest increases in the next three years are expected in the anticoagulants and diabetes classes. Insulins will continue to drive the diabetes trend in Medicare.
Medicaid Drug Spending
About 23% of the U.S. population is covered by Medicaid programs, including 15 million new beneficiaries who gained Medicaid coverage since the beginning of 2014. Total per-member per-year (PMPY) specialty drug spending accounted for nearly 36.5% of the total Medicaid drug spending in 2015, despite the small proportion of the Medicaid population utilizing specialty medications. In 2015, the HIV and hepatitis C therapy classes continued to lead Medicaid specialty drug trend, with eight of the top ten specialty medications, as ranked by PMPY spending, belonging to one of these two therapy classes. Medicaid is estimated to be the largest source of coverage for HIV care, covering half of all HIV patients in the U.S. The overall Medicaid trend increase in 2015 was driven by a 2.0% increase in utilization and a 3.7% increase in unit cost trend. Overall drug trend for traditional medications rose 3.3%, reflecting a 2.1% increase in utilization and a 1.3% increase in unit cost.
Other Significant Factors Contributing To The Rise In U.S. Drug Prices
According to Express Scripts, two significant contributing factors in the tremendous rise in prescription drug prices are pharmaceutical manufacturers who exploit monopolies with old generic medications and captive pharmacy arrangements, and compounding pharmacies that promote sales of high-priced, no-value compound medications.
If you or a loved one suffered injuries (or worse) as a result of a bad drug/defective drug in the United States, you should promptly seek the legal advice of a pharmaceutical claim lawyer in your state who may investigate your drug claim for you and represent you in a claim against a pharmaceutical company, if appropriate.
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