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Specialty Drugs More Than Doubled as a Share of Retail Fills

Analysis  |  By Jack O'Brien  
   November 02, 2020

The Health Affairs study looked at prescription drug data from 2010 to 2017.

Specialty prescription drugs more than doubled as a share of retail fills during a seven-year period, according to a Health Affairs study released Monday afternoon.

From 2010 to 2017, specialty drugs grew from a 1% share of retail fills to 2.3%, the study found. Additionally, specialty drugs accounted for 37.7% of retail and mail-order prescription spending net of rebates in 2016 and 2017. 

Related: 1.3% of Enrollees Account for Nearly 20% of Spending in Larger Employer Health Plans

The researchers, who are affiliated with the Agency for Healthcare Research and Quality (AHRQ), one of twelve agencies within the Department of Health and Human Services, found that specialty drugs accounted for nearly half of total spending on retail, mail-order, and provider administered drugs in 2018.

Similarly, spending net of rebates tripled for Medicare Part D beneficiaries and doubled for individuals with private health insurance during the seven-year research period.

Related: 17 States Have Implemented Prescription Drug Affordability Review Boards

According to the AHRQ researchers, the study has provided lawmakers and drugmakers with data as they aim to maintain incentives for developing specialty drugs while also paying for growing prescription drug spending.

The researchers suggested that greater price transparency could enhance competition, as well as a regulation that will take effect next year where the Centers for Medicare & Medicaid Services (CMS) will require that Part D plans "begin implementing systems that provide beneficiary-specific drug coverage and cost information in electronic health records."

The AHRQ study was released just over a year after a Willis Towers Watson (WTW) study found that about 40% of the WTW Rx Collaborative's total drug costs were the result of specialty drugs that account for less than 1% of prescriptions.

Related: Specialty Drugs Account for 40% of Employers' Drug Costs

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

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