Growth of patients with $50K annual drug tabs skyrockets

Specialty drugs continue to take a huge bite out of the pocketbooks of American insurers, employers and individuals, and the cost growth trend is "unsunstainable," according to a new study commissioned by Express Scripts.

Approximately 576,000 Americans spent more than the median U.S. household income on prescription medications last year, a 63 percent increase from 2013 alone, the study found. The population of those spending more than $100,000 a year tripled between 2013 and 2014, reaching 140,000. The combined cost to sustain these populations is "an unsustainable $52 billion a year."

Private health insurers and self-insured employers shouldered 98 percent of the costs for this population, paying an average of $156,911 per individual. Patients with drug costs of more than $100,000 paid an average of $2,782 out of pocket, while those with costs of between $50,000 and $99,999 paid an average of $1,773 out of pocket.

Ninety percent of those patients whose drug costs are more than $50,000 annually take specialty medications, and more than a third received treatment for 10 or more medical conditions.

Drugs to treat hepatits C and cancer were the biggest cost drivers. Hepatits C drug use jumped more than seven-fold in the high-cost population between 2013 and 2014, while nearly a third were prescribed some form of cancer drug.

Global spending on cancer drugs topped $100 billion for the first time last year, and Fortune magazine has predicted that the annual compounded growth rate for cancer drugs would run around 8 percent annually. Medicare drug spending also has recently broken the $100 billion per year mark, although much of the allocation is for fairly commonplace treatments.

Medications to control blood pressure were most prevalent among patients whose drugs cost more than $100,000 per year--some 57 percent took some drug to control this condition. Among the entire U.S. population, less than a quarter take blood pressure medications. The use of antidepressant medication was also widespread in this population--nearly 30 percent had a prescription for at least one antidepressant, compared to about 12 percent nationwide. 

Express Scripts recommended two avenues for cutting costs: Address wasteful spending on compounded drug therapies and introduce more programs to improve medication adherence.

To learn more:
- read the Express Scripts study 
- check out the Fortune magazine article

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