Biotechnology Healthcare - July/August 2008 - (Page 57)

TRENDS: UTILIZATION Growth of Specialty Drug Utilization Slows Over 4 Years Michael D. Dalzell, Editor The growth of specialty drug expenditures has been well chronicled, but annual rates of utilization increases have dropped steadily for years. According to Medco’s 2008 Drug Trend Report, overall utilization of specialty drugs increased 3.9 percent in 2007, down from a 7.3 percent increase the previous year, at least for Medco’s book of business. The decline was the fourth straight recorded by Medco, and although the pharmacy benefit manager’s experience solely reflects its own pharmacy management acumen, Medco represents 60 million covered lives — roughly a quarter of the covered U.S. population — enough to consider the results authoritative. So, if expenditures continue to rise by double digits — it was up 12.3 percent among Medco clients in 2007 — but utilization trends have moderated, what gives? Unit cost: Up 8.4 percent last year. Year to year, the top drivers of utilization trends differ, depending on what products enter the market or fall out of favor. In 2004 and 2005, for instance, the emergence of teriparatide (Forteo) drove large utilization increases in the osteoporosis class; in 2007, rapid sales of bosentan (Tracleer) and iloprost (Ventavis) led to strong uptake in pulmonary hypertension but overall utilization trends were slowed by a sharp drop in anemia agents, the fallout of safety concerns. Looking ahead, Medco predicts that specialty drugs for common and rare diseases, including a variety of autoimmune conditions, will be leading drivers of overall specialty drug cost-and-utilization trends. Top drivers of specialty drug trends Year-to-year percentage increases or decreases in utilization, by class 18.8 24.4 15.9 10.3 7.3 3.9 19.116.7 16.1 17.1 11.3 16.1 4.4 4.3 5.9 ’03 ’04 ’05 ’06 ’07 –9.5 –12.1 ’03 ’04 ’05 ’06 ’07 0.1 15.9 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 –12.1 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 Overall utilization Anemia Anticoagulation Growth hormone Hemophilia Hepatitis C Infertility 171.2 66.7 52.9 38.6 18.3 4.6 5.2 1.1 0.6 19.1 8.6 7.8 71.2 33.9 21.5 10.5 10.1 13.7 3.8 –3.0 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 ’03 ’04 ’05 ’06 ’07 Multiple sclerosis Oncology Osteoporosis Pulmonary hypertension Rheumatoid arthritis Autoimmune conditions* *Includes rheumatoid arthritis agents, which had been tracked separately until 2006. Source: Drug Trend Report, Medco Health Solutions, Franklin Lakes, N.J., 2008 JULY/AUGUST 2008 · BIOTECHNOLOGY HEALTHCARE 57

Table of Contents Feed for the Digital Edition of Biotechnology Healthcare - July/August 2008

Biotechnology Healthcare - July/August 2008 Openers Contents Editorial/David B. Nash, MD, MBA Drug Track Health Plan Confidential Rheumatoid Arthritis A Decade of Trial, Error, False Starts, and Hope What Path Will Comparative Effectiveness Research Take? RA Therapies in Development: A New Generation of Relief Assessing the Full Impact of RA on Employers and Payers Stem Cells: Health Insurance You Can Bank On Specialty Pharmacy Employer to Employer Personalized Medicine Trends Clinical Briefs

Biotechnology Healthcare - July/August 2008

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