According to a new report released by the IMS Institute for Healthcare Informatics, the cost of specialty drugs will continue to increase. In 2013, consumers increased their use of the healthcare system for the first time in three years as the economy slowly strengthened. While costs for prescription drugs have fallen in recent years, the small segment of the population that needs specialty drugs — such as cancer drugs — are seeing their treatments become more expensive.
The report found that the total amount spent on medications in the U.S. reached $329.2 billion last year. This increase is attributed not only to increased usage of the healthcare system, but also to the reduced impact of patent expiries, price increases, and higher spending on new medicines.
IMS researchers found that in 2013, only 2.3 percent of all prescriptions in the U.S. accounted for nearly one third of all out of pocket costs. That’s in comparison to the 86 percent of all prescriptions being filled with generic medicines that are generally affordable for patients. Caroline F. Pearson, the vice president of the Avalere Health consulting firm, said that insurers were shifting the high costs of these specialized drugs onto patients. “The new drugs coming to market are more specialized, and more tailored to smaller populations of patients, which tends to make them more expensive because fewer people are ultimately going to take them,” said Pearson.
Pearson also stated that 23 percent of employer-sponsored health plans now have specialty drugs in their own tier, which requires patients to pay a set percentage of their total costs, instead of a fixed co-payment. In 2006, only 5 percent of employer-sponsored health plans had a specialty tier, which represents a significant increase in the past 7 years. Pearson believes that the trend will continue as insurers look for ways to curb their costs for expensive specialty drugs.