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2009 Drug Trend Report (Medco)

2009 Drug Trend Report (Medco)

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Published by anidem-
Medical Trends
Medical Trends

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Published by: anidem- on Oct 09, 2009
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02/09/2013

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 D  U G  N D   O
 
 D  U G  N D   O
 
To our clients and friends:
We are pleased to share the Medco 2009
Drug Trend Report 
,
 
which chronicles an unprecedented year and identifiessolutions for the historic challenges ahead.As predicted, specialty drug trend accelerated dramatically, from 12.4% in 2007 to 15.8% in 2008. In addition, the priceinflation of branded pharmaceuticals increased more than 8%. Despite these trends, Medco clients in 2008 realized anaverage drug trend of 3.3%—a small increase from our all-time low in 2007.Among the insights revealed in this year’s report:
•
The weak economy drove renewed interest in generics, as the generic dispensing rate increased 4.4% to 64.1%.
•
About 30% to 40% of the medicines currently in the pipeline are specialty drugs, with nearly 25% of those targetingvery rare conditions.
•
Biologic or protein-based drug therapies account for about 16% of prescription drug spending and are growing at amuch faster rate than other drug categories.
•
Branded drug price inflation and unit-cost growth will be moderated by the wave of first-time generics inhigh-cost categories, which is expected to peak after 2011.We would like to underscore a finding that reinforces mail as a successful quality and cost strategy: Clients with 40% orgreater mail penetration had an average trend of -0.7%, while clients with less than 40% mail penetration had an averagetrend of 5.8%.During the past year, Medco has proven that evidence-based, protocol-driven pharmacy practice can help lead a clinicaltransformation. Our specialist pharmacists across 14
Medco Therapeutic Resource Centers
® provide condition-specificpatient care that is proven to close gaps in adherence and omission, and lower total healthcare costs. Linked to ourpharmacogenomics collaborations with the Mayo Clinic and other leading institutions, we are forming a foundation fora new era of precision medicine. And we are helping to shape the vital national discussion related to healthcare reform.This year’s
Drug Trend Report 
explores the many forces both driving and moderating trend—including the economic crisis,emerging technologies, and the continued growth of specialty, biologic, and first-time generic drugs. It also provides atimely update on issues related to the urgent need for enlightened national healthcare reform—one of the most pressingpublic policy debates of our generation.In this environment, we encourage you to collaborate with your account manager to closely monitor your planperformance and prepare for the changes and opportunities that lie ahead.Sincerely,David B. Snow, Jr. Robert S. Epstein, M.D., M.S.Chairman and CEO Senior Vice President, Chief Medical OfficerP.S. For additional copies of this report, please contact your Medco account representative. A searchable PDF is available at
www.drugtrend.com
.
 
1
2009
DRUG TREND REPORT
TABLE OF CONTENTSEXECUTIVE SUMMARY
2–17
SPOTLIGHT ON TREND FOR
2008
 
|
 
UNIT COST VS. UTILIZATION
18–45
2008 drug trend overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Unit cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Drug trend drivers and moderators . . . . . . . . . . . . . . . . . . . . . . .30Specialty healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Medicare trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39Demographics of trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41National trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
THE DYNAMICS OF FUTURE TREND 
|
 
GENERICS VS. SPECIALTY DRUGS
46–81
Trend projections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47Market projections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50Cardiovascular agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57Central nervous system agents . . . . . . . . . . . . . . . . . . . . . . . . .62Endocrine and diabetes agents . . . . . . . . . . . . . . . . . . . . . . . . .67Musculoskeletal and rheumatological agents . . . . . . . . . . . . . . . .70Respiratory agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75Oncology agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78Other therapeutic agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81
SETTING THE STAGE FOR REFORM 
|
 
PHARMACY AT THE FOREFRONT
82–99
Challenges in the current system . . . . . . . . . . . . . . . . . . . . . . . .83Wiring the healthcare system . . . . . . . . . . . . . . . . . . . . . . . . . 86Improving healthcare: Leveraging the pharmacy model . . . . . . . . 90The future of healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
REFERENCES
100-108

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