Dallas–(business wire)–Pharmaceutical Strategy Group (PSG), an EPIC company, has released its highly anticipated Artemetrx.® State of the specialty spending and trend report. The sixth-annual report uses integrated pharmacy and medical claims data to prepare a holistic view of specialty spending and trends. Since its inception in 2017, it has served as the only comprehensive analysis of specialty drug spending, powered by the industry-leading integrated dataset through Artemetrx.
“The specialty trend returned to pre-pandemic levels in 2021, rebounding to 14.2%,” said Michael Lonergan, RPh, president of PSG. “However, it is encouraging to see competition from biosimilars impact cost. We see an overall increase in utilization, from 12.4% in 2020 to 22.5% in 2021 and expect a more meaningful impact next year as biosimilars for Humira enter the market.
As of 2020, claims continue to drive usage trends. In fact, 9.4% of the 14.2% 2021 trend was due to increased claims utilization and 4.4% due to changes in cost per claim. Thus, while many high-cost treatments capture the spotlight, utilization is driving particular trends. We expect that as new expensive treatments are introduced for highly prevalent diseases such as migraine and asthma, the double-digit trend will likely continue.
“While the definition of specialty drug inclusion has changed since the inception of this report six years ago, the importance of active specialty drug program management has not changed,” said Renee Reberg, RPh, vice president of Specialty Clinical Consulting. “Our data provides the precision needed to track trend drivers and keep pace with rapidly changing market complexities, allowing for the creation of appropriate planning strategies,” Ryberg commented. “Access to integrated data creates the ability to align PBM and health plan strategies to achieve maximum financial benefit.”
“The Artemetrx specialty spend and trend report is an important tool to assist in the assessment and design of specialty pharmacy strategies,” noted Timothy Carroll, PharmD – VP, Business Development and Analytics, Reliance Rx. “This becomes even more necessary as new therapies, generics and biosimilars are introduced and paradigms continue to change.”
Key takeaways from the Spending and Trends report include:
Inflammatory conditions remain top ranked and Humira is the top drug in terms of overall plan cost. As biosimilars and specialty generics enter the market in 2023, this may change.
The percentage of specialty spending in the medical vs. pharmacy benefit is 64.5% pharmacy / 35.5% medical – reflecting a return to 2016 percentages.
Specialty drug plan costs continue to rise rapidly, reaching $1,295 per member per year (PMPY) — more than double the cost in 2016.
After a low trend of 11.8% from 2019-2020, possibly pandemic-related, the specific trend rebounded to 14.2% from 2020-2021.
Stable at 4.8% for 2019 and 2020, the percentage of the population using at least one specialty drug increased to 5.9% in 2021.
The 2022 State of Specialty Spend and Trends Report continues to reflect PSG’s legacy of tireless customer advocacy with a view of how payers and plan sponsors can transform insights into opportunities.
Follow this link to access the full report: https://www.psgconsults.com/specialtyreport2022
About the Pharmaceutical Strategy Group (PSG).
Pharmaceutical Strategy Group, an EPIC company, tirelessly advocates for clients as they navigate complex and ever-changing pharmaceutical cost management challenges. PSG’s innovative medication management solutions, including the proprietary data and analytics platform, Artemetrx®, deliver actionable insights with exceptional financial and clinical value. PSG acts as a strategic partner through industry-leading intelligence and technologies to achieve billions of dollars in pharmaceutical cost savings for clients each year. https://www.psgconsults.com/
Artemetrx is a proprietary SaaS platform developed by PSG, an EPIC company. As one of the first technology solutions in the market to integrate pharmacy and medical claims data for specialty drug cost management, Artemetrx continues to provide payers with market-leading specialty drug insights. It provides unparalleled intelligence and line-of-sight into the serious challenges of out-of-control drug costs and compromising patient outcomes. PSG’s innovative medication management solutions, including Artemetrx, deliver actionable insights with exceptional financial and clinical value. PSG acts as a strategic partner to achieve billions of dollars in pharmaceutical cost savings for clients each year through industry-leading intelligence and technologies. https://www.psgconsults.com/discoverartemetrx
About Reliance Rx – Report Sponsor
Reliance Rx provides national specialty pharmacy fulfillment and care coordination for complex disease conditions – resulting in greater efficiency, lower costs and improved services. Through enhanced communication between physicians, patients and its specialty pharmacies, Reliance Rx aims to achieve optimal therapy adherence and promote positive clinical outcomes. Providing the best possible care drives everything they do, from a truly personalized experience to the efficient delivery of specialty pharmacy services. https://www.reliancerxsp.com/.