WOONSOCKET, R.I. — Research from CVS Health highlights the sharp growth in spending for specialty medications, which is far outpacing expenditures on traditional prescription drugs.
CVS said late Monday that in an article published in the October issue of Health Affairs, data from its researchers shows that between 2012 and 2013, spending on specialty pharmaceuticals rose 15.6%, compared with just 0.8% growth for spending on traditional medications.
That trend stands to pick up steam, with specialty drug spending projected to grow by more than 16% annually from 2015 to 2018, accounting for approximately $235 billion — or more than half — of total drug spending by 2018.
"As specialty drugs begin to address the needs of an increasingly broad range of patients across several therapeutic areas, there is a growing need for solutions that drive the best patient outcomes at the lowest costs," Alan Lotvin, executive vice president of CVS/specialty at CVS Health, said in a statement. "Significant opportunities exist to bend the cost curve of specialty medications by eliminating waste, inducing price competition and reducing or preventing costly complications."
The article outlines drivers of rising costs, including the increasing complexity and effectiveness of new medications, the changing dynamics of target populations that enlarge the pool of patients eligible for treatment, and how and where specialty medications are delivered. It also examines how approaches that have helped manage cost growth for traditional medications over the past 10 years could be applied to specialty medications.
"Spending growth in specialty drugs is not a given," stated Troy Brennan, chief medical officer at CVS Health. "To slow cost growth, payers must be willing to embrace a variety of strategies used to manage traditional medications as well as some novel approaches that will require a multifaceted and holistic approach, including the collaboration of those who prescribe, dispense, deliver, pay for and receive specialty medications."
The authors also shed light on management strategies that help balance positive health outcomes while reining in soaring costs. These include applying traditional drug management plan design elements (such as prior authorization and step therapy) based on evidenced-based medicine, implementation of tiered formularies to stimulate price competition, and use of the lowest-cost site of care for delivery and administration of specialty medications.
