It’s time for Drug Channels’ annual analysis of drug spending. For 2017, we again turn to the annual trend reports from four large pharmacy benefit managers (PBMs)—CVS Health, Express Scripts, MedImpact, and Prime Therapeutics. (See their report links below.)
Below, I compare who’s better and who’s best among the PBMs and share additional observations about the 2017 trends. We offer four key conclusions:
- Drug spending grew by only 1.5% in 2017, continuing a multiyear decline in the growth rate.
- Total drug spending declined at more than 40% of plan sponsors.
- Spending on traditional drugs dropped by mid-single digits.
- For specialty drugs, higher utilization was a much bigger contributor to spending growth than was growth in unit costs.
The 2017 data figures show that PBMs’ negotiating abilities continue to put spending growth in a squeeze box. Unfortunately, the warped incentives of the gross-to-net bubble and plan sponsor cost-shifting mean that patients do not always get on the magic bus and benefit from the low trend figures.
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