Americans have almost doubled spending on specialty drugs from pharmacies, study finds

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Between 2010 and 2017, Americans nearly doubled spending on specialized drugs bought at pharmacies or by mail after representing rebates, according to a research study cited by STAT..

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The study, which count on data from the Medical Expenditure Panel Survey, defined specialized drugs as those with a median price of more than $600 for a 30-day supply in between 2010 and 2016 and those with an average cost of more than $670 in 2017.

In 2016 and 2017, typical yearly rebates for Medicare Part D totaled $14.9 billion, which made up 30 percent of gross spending on specialized drugs. Rebates for Medicaid totaled $9 billion, or $53 percent of gross spending. Refunds for private insurance coverage were $18.5 billion, or 24 percent of gross costs.

In 2017, specialized drugs accounted for 2.3 percent of filled retail prescriptions, compared to 1 percent in 2010.

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Specialty drugs made up 38 percent of retail and mail-order prescription spending in 2017, up from 20 percent in 2010. Investing tripled for Medicare Part D recipients and more than doubled for those with personal insurance coverage, according to the study, which was released in Health Affairs.

Seven things to understand about the research study, as reported by STAT:.

The most common retail specialized drugs in 2016 and 2017 were Eli Lillys Admelog/Humalog and Novo Nordisks Novolog, both diabetes medications; Eli Lillys Trulicity, likewise a diabetes drug; andAbbVies Humira, utilized to treat rheumatoid arthritis.

In 2016 and 2017, typical yearly rebates for Medicare Part D amounted to $14.9 billion, which made up 30 percent of gross costs on specialty drugs. Rebates for Medicaid amounted to $9 billion, or $53 percent of gross costs. Rebates for private insurance coverage were $18.5 billion, or 24 percent of gross costs.

From 2010 to 2017, typical yearly gross costs on specialized drugs for Medicare Part D beneficiaries increased from $13.5 billion to $50.3 billion, and net costs increased from $11.3 billion to $35.4 billion. For those with personal insurance, gross costs increased from $29.9 billion to $76.1 billion, and net spending increased from $24.6 billion to $57.6 billion.

Maia Anderson –
Wednesday, November 4th, 2020
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The studys authors stated there were some restrictions to the study, including that they may have ignored Medicaid rebates since they are confidential. The study also lacked different rebate rates for private insurance and Medicare Part D, and refunds paid to private insurance companies and Medicare Part D were most likely overstated for various reasons..

The development in spending comes despite the reality that specialty drugs make up a really small part of retail prescriptions filled. In 2017, specialized drugs accounted for 2.3 percent of filled retail prescriptions, compared to 1 percent in 2010. The proportion of people who have gotten at least one retail specialized drug more than doubled, from 2.2 percent in 2010 to 5 percent in 2017.