In Which PBM Best Managed Drug Spending in 2016: CVS Health, Express Scripts, MedImpact, or Prime?, I examined the 2016 drug trend reports from four leading pharmacy benefit managers (PBMs). OptumRx, the PBM business of UnitedHealth, released its report too late to be included in that analysis.
The charts below remedy this omission. The data now include five major PBMs, which accounted for more than 80% of equivalent prescription claims in 2016. After we add OptumRx’s results, the claims-weighted average increase in drug spending for 2016 was only 3.3%.
These results again confirm that the supposed drug spending problem is a myth. However, some patients experience significant out-of-pocket cost increases, due largely to cost-shifting by plan sponsors. With such low overall spending growth, the next battle will be over how best to share the savings from PBM-negotiated rebates.
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