Specialty Trend Keeps Growing ... and Growing!

Specialty drugs are rapidly consuming an ever-greater portion of what Americans spend every year for prescription drugs. From a plan sponsor's perspective, these highly expensive drugs, which remain poorly controlled, pose a growing threat. Last year's specialty spend was $59 billion — that's 21% of the country's total pharmaceutical spend. That percentage will reach 27% by 2011, with specialty drugs costing $98 billion, compared with $267 billion for conventional drugs.

Cost management begins with understanding the drivers of specialty trend. What Drives the Cost of Specialty Drugs? The average specialty drug costs $1,600 for a 30-day supply. Although specialty trend dropped from 20% to 14% in 2007, per-member-per-year costs still ran $84.73. Specialty drugs have certain characteristics — frequent dosing adjustments and intensive clinical monitoring, for instance — that drive up their cost. In addition, distribution is commonly limited or exclusive to one company, and most specialty drugs require specialized handling and administration. Initially used mostly for complex conditions, specialty drugs are now prescribed for more common ailments, such as asthma and psoriasis. In addition, growing direct-to-consumer advertising has spurred demand for specialty drugs. If we consider specialty drugs as a combined therapy class, it's now outpaced anticholesterol medications, which ranked as the No. 1 class in 2006. The primary reason for the growth in specialty-drug spend between 2006 and 2007 was the increased utilization of these expensive drugs.

Ninety percent of the money spent on specialty medications goes to treat seven conditions:

Cancer (19.7% trend)
Inflammatory conditions, including rheumatoid arthritis and other conditions (18.1% trend)
Multiple sclerosis (16% trend)
Conditions treated with anticoagulants (17.3% trend)
Blood cell deficiency (-9.7% trend)
Growth deficiency (6.3% trend)
Hepatitis C (0.6% trend)

While all of this being said, how do you tackle this trend? Revera Health has developed a suite of integrated solutions that address the areas impacted by this increasing trend. Revera Health can develop customized programs for an self funded group or health plan that preserves patient choice, ensures appropriate care, and delivers measurable cost savings.

Revera Health is inventing an industry. Revera Health's solutions integrate medical and pharmacy benefits under a single platform; thus providing real time reporting and medical management.

To learn more, visit www.reverahealth.com or contact us at future@reverahealth.com

We look forward to providing valuable insight to our clients and prospective clients. We will continue to post information on the topics of specialty pharmacy, medical benefits, pbm, pharmacy benefits, biotech pipeline, alternative sites 0f care, and more.