1. Health Strategies Group
1/15/2019
Health Strategies Group
Author/Artist
Specialty Costs Will Account for a Greater Share of Pharmacy Spend across Segments
Payers anticipate spend for generics and traditional products will continue to decrease across both commercial and government business, while specialty costs will continue to increase.
Payers recognize the success of their cost containment efforts for traditional products and will continue to turn their attention to specialty drugs and biosimilars in an effort to achieve similar results and control cost growth and increasing utilization in those areas.
While the biosimilar market has been slow to develop in the United States, payers anticipate an increase in coverage over the next few years and expect a greater portion of their pharmacy spend to go towards these drugs.
Health Plans Attribute More than One-Fourth of Their
Pharmacy Spend to Specialty Drugs across Segments
(Average percentage of pharmacy spend)
ᵃHealth plan projections. Commercial N=35, MA-PD, N=30; PDP, N=14; Medicaid, N=16 Source: Health Strategies Group, KnowledgeEdge, Insurance and Benefit Design, February 2018.