Research highlights safety, cost challenges

As pharmaceutical companies introduce more high-cost medications for larger populations, employers, health plans and others are challenged to control the significant increase in spending and increased medical safety concerns, according to a report from prescription manager Express Scripts.

The new report, Super Spending: US Trends in High-Cost Medication Use, examines prescription drug use among patients with exceedingly high annual medication costs under the pharmacy benefit. The number of US patients estimated to have annual medication costs greater than $50,000 jumped 63 percent between 2013 and 2014, from 352,000 to 576,000 Americans. The population of patients estimated to be taking at least $100,000 worth of medication nearly tripled in the same time period, from 47,000 to 139,000 Americans.

"The profile emerging from this research shows these patients are overwhelmingly taking specialty medications, and have multiple comorbidities, prescriptions and prescribers," said Dr Glen Stettin, senior vice president, Clinical, Research and New Solutions at Express Scripts. "These insights highlight clear opportunities for payers to work with their PBM to improve care, quality of life and health outcomes for the patients who rely on these costly, complex therapies."

Nine out of 10 patients with drug costs of $50,000 used specialty medications, which are expensive treatments for complex conditions. However, the analysis reveals patients at the top of the pyramid of prescription spending are often afflicted with numerous comorbidities that add to the complexity and cost of their care.

"Patients in these highest-spend categories are treating a complex condition along with other more common chronic conditions, such as diabetes or depression, which can leave them at risk for medication safety concerns and increased medical costs," said Dr. Stettin. "When we treat the whole patient, as we do in the Express Scripts Therapeutic Resource Centers and our specialty pharmacy, Accredo, we provide a home pharmacy that offers integrated, coordinated care with other members of the patients' healthcare team. The result is more efficient, effective and personalized patient care."

Express Scripts, Express Scripts Therapeutic Resource Centers, pharmaceuticals, healthcare costs