Specialty drugs are used for the treatment of complex, chronic, or rare conditions such as cancers and hepatitis C. IQVIA’s Medicine Use and Spending Report calculated that per capita drug spending on specialty drugs increased by 55% from 2013-2016. Podcast episodes examine current trends, key conferences, and critical topics in the industry. THE SHIFTING LANDSCAPE ACCESS TRENDS IN SPECIALTY PHARMACY 2020-23 7 US specialty drug spending saw a modest annual growth of 3%, from 44.7% in 2018 to 47.7% in 2019 per ESI.10 On the basis of non-discounted spending, specialty growth has been outpacing traditional product growth, with a 10% to 0.3% dollar volume increase, per IQVIA. While initially often opened independently, many specialty pharmacies have been acquired by traditional chain pharmacies and investment firms in recent years. These therapies bring life changing treatment options and hope to many people who are dealing with rare genetic diseases. continued strong growth … Direct and indirect remuneration (DIR) fees are not going away in 2020 and, in fact, we expect them to grow. Specialty drugs are developed mostly for chronic and degenerative diseases like rheumatoid arthritis, cancer and multiple sclerosis. by Denise Cabrera. Dr. Adam J. Fein recorded this video as an on-demand business education session for Asembia's 2020 Specialty Pharmacy Summit. About The Author. The State of Specialty Pharmacy 2020: Market Data ... Why Do CVS And Express Scripts Rely on Secretive P... Copay Maximizers Are Displacing Accumulators—But C... Walgreens and CVS Top the 28,000 Pharmacies Profit... PBMs and Drug Spending in 2019: CVS Health and Exp... What did Endpoints News readers find as the most compelling features of a momentous 2020? Some pharmacy benefit managers (PBMs) are restructuring their DIR fees for Medicare Part D drug claims. Stanton D. In the pipeline: Surge of cell and gene therapies likely in 2020. Specialty drugs are chemically more complex and are referred to as biologics because they are derived from living organisms or their products, such as a human or animal protein, hormone or antitoxin. The cost of $850,000 will be partially reimbursed if a patient fails to respond to treatment. Specialty Pharmacy Keeps Disrupting Buy-and-Bill—and COVID-19 Will Accelerate It (rerun) ... 2020, update on COVID-19 trends.) 2020-01-31 15:32:00. Learn from Specialty Rx Experts: 1st Episode of AscellaHealth Educational Webinar Series “Specialty Market Trends and the Market Place Realities for Pharmacy Benefit Managers” It is estimated that 17% of America’s personal healthcare spending is for drug therapy.1 With the rise of personalized medicine and gene editing therapy drug spend is projected to reach $600B in 2020. State of Louisiana’s contract with Asegua/Gilead allows unrestricted access of the drug Epclusa, to treat and cure Hepatitis-C, for their entire Medicaid and prison population. Healthcare will … Unique models are being considered in order to manage patient access and cost of care. These high investment therapies have stretched current reimbursement models beyond their capacity. Value based arrangements and risk sharing across plan sponsors, PBMs, Payers and manufacturers is being considered in order to sustain affordability, ensure access to care and continue to incentivize manufacturer research and development efforts. Novartis expects to treat 100 infants each quarter. Precision medicine targets specific genes, based on the patient’s condition. Pembroke Consulting, Inc., and. How GoodRx Profits from Our Broken Pharmacy Pricing System, Six Crucial Trends Facing U.S. Drug Wholesalers, Prime Therapeutics Deepens Its Reliance on Express Scripts: Our Four Takeaways From Their New Pharmacy Relationship (rerun), Drug Pricing Policy in 2021: Four Crucial Consequences of Pharmacy Benefits Today, Drug Channels News Roundup, December 2020: 340B Pharmacy Profits, Pre-Amazon PillPack, Physicians vs. Accumulators, Maine’s Importation Fail, and Vaccine Humor. Medical pharmacy trends continued to climb with commercial PMPM increasing 10 percent year over year. Specialty and high-cost medications continue to dominate the news. Pharmacy Outlook. Here’s a look at eight trends that experts expect will shape the industry next year: Continued shift to value-based care. Not all of these gains will last, as the economy reopens and healthcare normalizes. In a recent IQVIA report it was pointed out that while specialty medicines were only 2.2% of prescription volume it is projected that by the end of 2020 specialty medications will account for nearly 50% of the nation’s drug spending. do not make investment recommendations, on this website or otherwise. You can watch the full video below. and the author shall not be responsible for any liability arising from or related to the use or accuracy of the information in any way. It is a pre-exposure prophylaxis for HIV and will have the potential to impact nearly $3B in annual sales. Sales of Zolgensma totaled $361M in 2019. Diagnosis and Treatment of IBS. Videos. Paying a fixed fee for use of the drug, over the next five years, will allow them to treat over 30,000 individuals by 2024. The first biosimilar was launched in the U.S. in 2015. Trends in FDA approval of Specialty Drugs 1990 through 2017, RJ Health, 2018. Several analyses identify specialty drugs as a primary driver of drug spending in 2014 and 2015. It would not address short term budget issues but would prevent hospitals from marking drug costs up significantly and avoid issues with DRG payments. increasingly innovative strategies. Medical Pharmacy Trend Report For 10 years, the Magellan Rx Management Medical Pharmacy Trend Report has unlocked pharmacy trend updates and emerging strategies to manage rising specialty spend on the medical benefit. Nothing on this website should be interpreted as an opinion by Pembroke Consulting, Inc.. or the author on the investment prospects of specific companies. Specialty pharmacies are designed specifically to manage the necessary handling, storage, and distribution of complex therapy drugs that require high-touch patient management. Specialty pharmacy has been a top trend for the past several years as utilization and drug spend have dramatically increased across healthcare. Here are six developments we believe are worth watching and the ways that action today can help people and communities across the United States on their path to better health. Spark Therapeutics has agreed to VBR for its gene therapy, Luxturna, which cures a retinal disease causing blindness. Specialty drugs are expected to represent almost 50 percent of total prescription drug spending in 2020. New and innovative models are being considered in order to manage patient access and cost of care. Total trend could rise slightly, reflecting higher drug prices, as insulins are considered biologics from March 2020. 1 Unique Reimbursement Models for High Investment Therapy. The biosimilar for Truvada is expected to launch in 2021. Puts the onus on the Payer to prove failure of efficacy. Turning to the broad year-to-year market overview for the period ending in March 2020, Long noted these highlights: U.S. medicines’ total market growth reached 6.7%, less than the growth of 7.4% in the retail and mail order segments. ... Next Top 15 Camera Podcasts You Must Follow in 2020. A biosimilar for Tecfidera, used to treat multiple sclerosis, should launch 3Q2020 with the potential to impact annual sales of $3.5M. Denise CabreraLicensed Clinical PharmacistNational Pharmacy Practice Leader   McGriff Employee Benefit Solutions813-682-1515Denise.Cabrera@mcgriffinsurance.com, Specialty Pharmacy Trends for 2020 and Beyond, Register: Online HRCI | PHR | SPHR Certification Exam Prep Class, https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet, https://bioprocessintl.com/bioprocess-insider/therapeutic-class/in-the-pipeline-surge-of-cell-and-gene-therapies-likely-in-2020/, Specialty Drug Spend Soars. Volume Based Purchasing – the Netflix Model. Changing DIR fee structure. Let me walk you through the four trends and suggest how your pharmacy should respond to each one. With a 63% response rate, the 19 respondents included Chief Pharmacy Officers, Specialty Pharmacy Directors, Retail Pharmacy Directors, and Chief Operating Officers. Specialty Pharmacy. They estimate a savings of over $470M over the next five years in addition to a reduction of medical costs to treat progression of the disease. Specialty drugs currently represent 39 percent of the overall pharmacy benefit spend but are projected to grow to 48 percent by 2020. Specialty Pharmacy Keeps Disrupting Buy-and-Bill—a... Preorder now: The 2020-21 Economic Report on Pharm... Three Ways to Boost Patient Access to Orphan Drugs... My Wall Street Journal Op-Ed about the 340B Program. 2 Emerging Trends in the Specialty Drug Industry Brought to you By: S ... $400 billion by 2020.3 Clearly, the use of and spend on specialty drugs in ... snapshot of specialty pharmacy mergers and acquisitions in 2016.4 To properly serve their patients, pharmacists working in the outpatient setting—whether or not SPECIALTY TREND DRIVERS Utilization of specialty drugs continued to be the largest driver of trend, as specialty drugs represented 37% of Prime’s pharmacy benefit spend. 1 With the rise of personalized medicine and gene editing therapy drug spend is projected to reach $600B in 2020. BioProcess International. ... Growth of specialty market (2015-2020) THE SHIFTING LANDSCAPE CERTARA TRENDS BRIEF 5 US specialty drug spending saw … Significant advancements will bring curative therapies to many individuals suffering from rare hereditary diseases. As specialty drugs have gained a stronger foothold in the United States, the creation and utilization of specialty pharmacies has also expanded. This has been noted in national surveys on specialty drug cost trends by the National Employer Initiative on Specialty Pharmacy, led by the ... Planning a Specialty Drug Strategy Through 2020 . New pharmacogenomic tests and gene therapies are entering the market at an astounding rate and are expected to grow by 10.5% over the next five years. Specialty Pharmacy Trends for 2020 and Beyond. Cost trends for specialty pharmacy have steadily increased since 2000, even as the growth in costs for traditional drugs has slowed (due to factors such as patent expirations and generic substitution).12 Recent research suggests that per capita growth for specialty drugs is in the double-digits: Spark agreed to the same terms for Luxterna to treat a retinal disease causing blindness. Gene therapy is designed to correct inherited genetic defects therefore it is curative and preventative for future generations.The FDA has approved 4 gene therapies to date, including Zolgensma (Novartis), approved to treat a rare spinal defect. Progress has been exceptional but these high investment therapies have also introduced new challenges for employers and the payer community.4The 1983 Orphan Drug Act was enacted to incentivize research for rare diseases which are estimated to afflict 10% of Americans. Nine specialty drugs have lost their patent however only six of them have actually launched a biosimilar due to patent protection, patent litigation and manufacturing challenges. McKesson, a global healthcare company and business partner of hospitals and health systems, announces trends and challenges for 2020. 1. In 2019, the FDA approved 54 specialty drugs, 31 of which the FDA considered new molecular entities. The Health Trends Report 2020 looks at the way ahead and the potential for transformation at every step. There is a $62B market for biosimilars over the next four years as competition in the specialty drug market increases. Novartis has agreed to annuity payments for Zolgensma over five years. Can Formulary Management Bring It Down to Earth?, Managed Care, 2019, FAQs About Rare Diseases, Genetic and Rare Diseases Information Center, U.S. Department of Health and Human Services, 2017, https://www.cigna.com/newsroom/news-releases/2019/pdf/cigna-health-services-business-pioneers-an-innovative-solution-to-affordably-bring-life-changing-therapies-to-patients.pdf, http://image.messageinsite.com/lib/fe5615707d600c747210/m/2/757027d4-dff0-4c1b-a50a-ce78326b9917.pdf, 5 Ways Talking to Strangers May Boost Your Emotional Intelligence, Driving Optimal Results Through Individual/Team Performance-Based Incentive Compensation Plans, The Future of Benefits Administration Technology for HR Professionals, Most Brokers Say They Have All the Answers, COVID-19 and Mid-Year Plan Amendments – Employer Compliance Checklist, 7 Steps to Take When a Star Employee Disengages, University of Memphis – Academic Training in HR Management, Is Western Governors University Accredited | Read the Latest World News - News World, The Three Top Challenges to Earning a Degree, Factors in Assessing Your Hiring Strategy - HRProfessionalsMagazine, Recruiting Tips During Times of Uncertainty, Gloria Sinclair Miller, SHRM-SCP, SHRM Field Services Representative, Dr. Kathy Tuberville Recipient of 2020 HR Professional Excellence Award, Profile: Emily M. Dickens, SHRM Corporate Secretary and Chief of Staff, Preview of SHRM-Atlanta SOAHR Conference March 25-27. When we look back ten years from now, my hope is that we can say “remember when we treated cancer with toxic chemo therapy and genetic disorders went relatively untreated?” That will certainly make the hard work we have to do well worth it. Genetic information is gathered through genome sequencing where researchers are able to identify specific abnormalities and come up with drugs and therapies targeted towards them.