Total spending on medications to treat high blood pressure and high cholesterol decreased 7.7 percent, primarily driven by the continued impact of patent expirations for blockbuster drugs.Drivers of Specialty Drug Trend Specialty drug trend continues its year-over-year double-digit growth. During the first three quarters of 2012, spending on specialty medications increased 22.6 percent over the same period in 2011, primarily driven by unit cost increases. In the first nine months of 2012, specialty drug costs consumed 20.8 percent of total pharmacy spend. "The continued rise in spend on specialty medications underscores the nation's need to accelerate the pathway for biosimilars," Dr. Miller said. "Additional competition within these therapy classes would provide a necessary market control against price inflation." The three therapy classes representing the largest amount of specialty drug spend continue to be rheumatoid arthritis/autoimmune conditions, multiple sclerosis and cancer. Medications commonly used to treat hepatitis C continue to have the largest specialty spend increase, 117.3 percent over the same period in 2011. Increased utilization is driving this trend, as new patients begin and continue treatment with one of two new medications. Eight of the nine notable new medications approved in the third quarter are specialty medications. Many of these medications are second-line and third-line drugs indicated to treat advanced cancers. Spotlight on Obesity Medications The report reviews the two new anti-obesity medications approved this summer by the U.S. Food and Drug Administration. In clinical trials, many patients taking either of the new medications lost at least 5 percent of their body weight. "The potential benefits of these new anti-obesity medications need to be compared against their risks and cost," Dr. Miller said. "We are cautiously optimistic about the possibilities of these and other drugs like them, provided that they are prescribed appropriately and integrated with other lifestyle modifying programs that help patients make healthier choices that maintain their weight over time."