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Drug Prices + Utilization Rates = Spending Changes

06.09.2016

prescription and drug pricesThe following table represents 2015 average spending changes for the customer base of Express Scripts, the largest U.S. pharmacy benefit management company. The data is based on the combination of changes in drug price and utilization rates for the top 10 conditions treated with “traditional” medications (as opposed to the expensive and more narrowly targeted “specialty” drugs). The table also shows utilization rates for generic drugs within each category. Higher generic utilization rates indicate availability of competitively priced generic drugs plus incentives built into drug benefit plans for employees to use those drugs.

2015 changes for top 10 medical conditions
Spending rank Condition Utilization rate + price trend Generic drug use rate
1 Diabetes 14% 52%
2 Pain/inflammation 3% 94%
3 High cholesterol -9% 83%
4 Attention disorders 9% 74%
5 High blood pressure / heart disease -13% 96%
6 Heartburn/ulcer 36% 92%
7 Mental/neurological disorders 0% 78%
8 Asthma -2% 43%
9 Compounded drugs -54% 36%
10 Skin conditions 28% 86%
Source: Express Scripts 2015 Drug Trend Report


Although higher utilization rates for drugs treating particular conditions raise drug costs, they can also mean a reduction in overall health benefit spending. How so? Because, when employees comply with prescription instructions, they’re more likely to have a positive medical outcome than if they opt for an alternative therapy method or delay treatment altogether.

Ron M. Present, CALA, CNHA, LNHAHave questions about your health care strategy? Contact Ron Present, Partner and Health Care Industry Group Leader, at rpresent@bswllc.com or 314.983.1358.

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