Express Scripts reveals drug classes that are driving spending growth

Drug prices
Express Scripts released its annual look at drug trend. Here's the classes the PBM giant says are driving higher spending. (Getty/Charles Wollertz)

Drugs for inflammatory conditions drove nearly half of spending in commercial plans last year, a new report shows. 

Express Scripts released its annual Drug Trend Report, which analyzes costs and spending for 33.6 million members enrolled in one of its drug plans.

The pharmacy benefit manager found that medications for inflammatory conditions such as psoriasis and rheumatoid arthritis drove 43.7% of spending, by far the highest among the different classes.

By comparison, diabetes and oncology drugs each contributed less than 20% of spend, the report shows. 

Drugs for these conditions drove the largest portion of trend for Medicaid and health insurance exchange plans, while oncology drugs overtook the top spot by a wide margin for Medicare beneficiaries, accounting for 36.4% of the increase in Medicare spending, according to the report. 

RELATED: Express Scripts selects first crop of tech tools to include on new digital health formulary 

So where did payers save money?

Costs for both drugs to treat pain and inflammation and for asthma medications declined significantly, the report found. They reported that a 15.5% decrease in unit cost for pain medications led to an 18.8% decrease in spending on these products. 

Unit costs for branded asthma drugs also decreased, leading to 15.6% less spending in this area, according to the report. 

Overall, Express Scripts’ drug trend—or the year-over-year percent change in per-member annual spending—increased by 2.3% in 2019. The PBM touted this as the third year in a row that it’s kept that increase under 3% even as drug prices continue to rise. 

Brand-name drugs saw prices inflate by 70.5% between January 2014 and December 2019, according to the report, while the price of household goods increased by 9.9% in the same window. 

Prices for generics, meanwhile, significantly plummeted, according to the report—declining by 40.9% over those five years. 

RELATED: Express Scripts launches value-based cardiovascular care program 

The impact of specialty drugs is continuing to grow, according to the report. Though these products account for just 2% of prescriptions, they were responsible for 47.7% of spending in 2019, up from 44.7% the year prior. 

Express Scripts has launched a series of solutions aimed at helping its health plan clients better manage rising drug costs. The PBM said it helped insurers save $49.5 billion in 2019. 

A critical approach, according to the report, is its SafeGuardRx platform, a value-based model that reaches 46.9 million members. Through that tool, plans saw significant savings across all therapeutic categories. 

Plans participating in SafeGuardRx saw an increase in per-member annual spending of 1.2% in 2019, according to the report. These plans saw slightly lower costs for pricey conditions like oncology and inflammatory diseases, and saw a 5.4% drop in spending for diabetes, while other plans saw an 8.5% increase.

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