Tuesday, February 16, 2016

Rx News: 70/30 is the new 80/20

It's a truism that (for example) 20% of one's customers create 80% of one's problems; the ratio is applicable to many other situations, as well.

But one area where it's apparently not is specialty meds:

"3 percent of the total pharmacy prescriptions are considered specialty, but they cost 30 percent of a plan’s overall pharmacy expense."

I should point out that this isn't exactly groundbreaking news; as we reported almost 6 years ago, "[a]ccording to UHC, "specialty medications" (e.g. injectibles) are used by less than 1% of its insureds, but represent an astonishing 20% of its pharma claims." And of course, med's are a major driver of health insurance costs, which is why we're seeing so many of them being moved to higher (and more expensive to the insured) tiers.

As pointed out in the article linked above, pharma costs increased 13% in 2014, driven in large part by "a 30.9 percent increase in spending on specialty pharmaceuticals." And it's only going to become worse as the population ages, generating demand for more and more meds to combat chronic conditions like arthritis and Alzheimers.

Happy days, indeed.

[Hat Tip: Allison Bell]
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