Exclusive report on the state of spending and trends of the specialty published by Pharmaceutical Strategies Group


DALLAS–(BUSINESS WIRE)–Pharmaceutical Strategies Group (PSG), an EPIC company, has released its highly anticipated Artemetx® Specialty Expenditure Statement and Trend Report. The sixth annual report uses integrated drug and medical claims data to provide a comprehensive view of specialty spending and trends. Since its inception in 2017, it has served as the only comprehensive analysis of specialty drug spending, powered by the industry’s leading integrated dataset via Artemetrx.

“The specialty trend returned to pre-pandemic levels in 2021, rebounding to 14.2%,” said Michael Lonergan, RPh, President of PSG. “However, it is encouraging to see competition from biosimilars impacting costs. We have seen an overall increase in utilization, from 12.4% in 2020 to 22.5% in 2021, and we expect more significant impact as biosimilars for Humira enter the market next year.”

As in 2020, the use of claims continues to drive the trend. In fact, 9.4% of the 2021 trend of 14.2% was due to increased use of claims and 4.4% to changes in cost per claim. So while high-cost therapies are capturing attention, utilization is driving the specialty trend. We predict that as new, expensive therapies for higher prevalence diseases such as migraines and asthma are introduced, the double-digit trend will likely continue.

“While the definition of what includes specialty drugs has changed since this report was created six years ago, the importance of proactive management of specialty drug programs has not changed,” said Renee Rayburg, RPh, Vice President of Specialty Clinical Consulting. “Our data provides the precision needed to track trend drivers and keep pace with rapidly changing market complexities, enabling the construction of appropriate plan strategies,” commented Rayburg. “Access to integrated data creates the ability to align PBM and health plan strategies to achieve maximum financial benefit.”

“The Artemetrx Specialty Spend and Trend Report is an important tool to aid in the evaluation and design of a specialty pharmacy strategy,” noted Timothy Carroll, PharmD – VP, Business Development and Analytics, Rx dependency. “This becomes more critical as new therapies, generics and biosimilars are introduced and paradigms continually change.”

Key takeaways from the spending and trending report include:

  • Inflammatory conditions remain the top category and Humira the top drug in terms of overall plan cost. As biosimilars and specialty generics enter the market in 2023, this may change.

  • The percentage of specialist expenditure on medical benefits compared to pharmaceutical benefits is 64.5% in pharmacy / 35.5% in medicine, which reflects a return to the percentages of 2016.

  • The cost of the specialty drug plan continues to grow rapidly, reaching $1,295 per member per year (PMPY) – double the cost from 2016.

  • After a downward trend of 11.8% compared to 2019-2020, probably linked to the pandemic, the 2020-2021 specialty trend rebounded to 14.2%.

  • Stabilizing at 4.8% for 2019 and 2020, the percentage of the population using at least one specialty medicine increased to 5.9% in 2021.

The 2022 Specialty Spending and Trend Report continues to reflect PSG’s legacy of relentless customer advocacy with insights into how payers and plan sponsors can turn insights into opportunities.

Follow this link to access the full report: https://www.psgconsults.com/specialtyreport2022

About the Pharmaceutical Strategies Group (PSG)

Pharmaceutical Strategies Group, an EPIC company, tirelessly advocates for customers as they face complex and ever-changing drug cost management challenges. PSG’s innovative medication management solutions, including proprietary data and analytics platform, Artemetrx®, deliver actionable insights with exceptional financial and clinical value. PSG operates as a strategic partner through cutting-edge intelligence and technology to deliver billions of dollars in drug cost savings for customers each year. https://www.psgconsults.com/

About Artemetrx®

Artemetrx is a proprietary SaaS platform developed by PSG, an EPIC company. As one of the first technology solutions on the market to integrate pharmaceutical and medical claims data for specialty drug cost management, Artemetrx continues to provide payers with cutting-edge specialty drug information. It offers unparalleled intelligence and line of sight to serious challenges that perpetuate spiraling drug costs and compromise patient outcomes. PSG’s innovative medication management solutions, including Artemetrx, deliver actionable insights with exceptional financial and clinical value. PSG operates as a strategic partner through advanced intelligence and technology to achieve billions of dollars in drug cost savings for customers each year. https://www.psgconsults.com/discoverartemetrx

About Reliance Rx – Report Sponsor

Reliance Rx provides nationwide specialty pharmacy execution and care coordination for complex medical conditions, resulting in greater efficiency, lower costs and improved services. Through improved communication between physicians, patients and its specialty pharmacy, Reliance Rx aims to achieve maximum adherence to appropriate treatment and promote positive clinical outcomes. Providing the best care possible guides everything they do, from a truly personalized experience to the efficient delivery of specialty pharmacy services. https://www.dependencerxsp.com/.


Comments are closed.