Downers Grove, IL – Coventry recently announced the release of the fourth part of its 2016 Drug Trends Series, which is based on all calendar year transactions billed through its PBM Program, First Script, as well as transactions from medical bill review to reflect the total pharmacy experience for their client base.
When releasing the previous parts of its report, Coventry noted that they are continuing to present data for traditional, managed, and unmanaged views; however, they are now sharing the information in shorter, more-condensed pieces delivered every few weeks vs. one large manuscript.
This fourth installment of the series is dedicated to specialty drugs and closed formularies. Specialty drugs, which are typically used to treat patients with complex, chronic conditions, have become widely discussed in workers’ comp due to their exorbitant per-prescription costs. Although they represent only 1.1% of drug utilization, they account for nearly 5% of prescription drug costs.
This final edition will share aggregate specialty drug information and review the differences in specialty cost and utilization among the managed and unmanaged views.
Key trends from this piece included:
Aggregate Specialty Medications
- Usage of specialty medications rose 0.1% point from 1.0% of all medications in 2015 to 1.1% in 2016.
- Costs associated with specialty medications increased 1.1% points from 3.8% in 2015 to 4.9% in 2016.
Managed Specialty Medications
- 19.4% increase in scripts per claim
- 7.9% increase in cost
- Specialty medications accounted for 0.65% of all prescriptions and 3.98% of all costs.
Unmanaged Specialty Medications
- 3.4% increase in scripts per claim
- 29.5% increase in cost
- Accounted for 2.5% of all prescriptions and 7.9% of all costs.
View Part 4 here: Coventry 2016 First Script Drug Trends Report Series, Part 4 (PDF)
View Part 3 here: Coventry 2016 First Script Drug Trends Report Series, Part 3 (PDF)
View Part 2 here: Coventry 2016 First Script Drug Trends Report Series, Part 2 (PDF)
View Part 1 here: Coventry 2016 First Script Drug Trends Report Series, Part 1 (PDF)
Coventry is a WorkCompWire ad partner.
This is not a paid placement.