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U.S. Spending On Specialty Medications Likely To Increase 67 Percent Through 2015

ST. LOUIS, May 21, 2013 /PRNewswire/ -- U.S. spending on specialty prescription drugs — those used to treat chronic, complex diseases such as cancer, multiple sclerosis and rheumatoid arthritis — is projected to increase 67 percent by the end of 2015, according to a forecast released today by Express Scripts (NASDAQ: ESRX).


"As we see what's on the horizon, it's time for employers and health plans to act so they can continue to offer an affordable pharmacy benefit for their members," said Glen Stettin, M.D., Senior Vice President, Clinical, Research and New Solutions at Express Scripts. "New specialty treatments are making a real difference in the lives of patients, but the very high cost of these drugs creates difficult decisions for plan sponsors on which medicines to cover."

Three of the Four Costliest Prescription Therapy Classes Will Be Specialty Conditions

Specialty medicines are prescription drugs that require special handling, distribution and administration. Many specialty medicines are biologics that are delivered via an injection or an infusion and are used to treat chronic, complex diseases.

Prescription drug spending on eight of the top 10 specialty therapy classes will continue to increase over the next three years. This is due to both the robust pipeline of new biologics and physicians delaying treatment of patients until the new drugs are on the market. By the end of 2015, Express Scripts expects that cancer, multiple sclerosis and inflammatory conditions such as rheumatoid arthritis — all specialty conditions — each will command higher drug spending than any other therapy class except diabetes.

Hepatitis C drug spending likely will quadruple over the next three years, the largest percentage increase by far among therapy classes. By the end of 2015, spending on medications for Hepatitis C will exceed that of much more common conditions, including high blood pressure. This increase will be caused by new interferon-free medications expected to gain FDA-approval in 2014, as well as an increase in diagnoses related to new screening guidelines. 

"Plan sponsors can greatly improve the utilization trend and overall spending that we project over the next three years by taking control of the pharmacy benefit today," said Dr. Stettin. "A recent study demonstrated that payers who implemented Express Scripts' cost management and patient care programs achieved 50 percent lower increases in specialty drug spending than payers who didn't. Importantly, these plan sponsors also saw higher medication adherence rates, which equates to better health outcomes for patients, while saving tens of millions of dollars."

Additionally, hepatitis C patients who received specialized clinical care from Express Scripts' specialty pharmacy, Accredo, were 60 percent more likely to achieve optimal adherence levels, and had more concurrent therapy days – which leads to overall medical savings by curing the patient and avoiding further disease progression.

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