In the Express Scripts Exchange Pulse Report, analyses showed medications for hepatitis C virus infection are the third most expensive specialty medications among exchange plans over a 15-month period, according to a press release.
The report compares prescription medication use among exchange plan enrollees to those who are enrolled in a traditional health plan, according to the release. The analysis examined medication trends from January 1, 2014 to March 31, 2015, and also compared trends in quarter 1 of 2015 to those in quarter 1 of 2014. “The analysis is based on more than 100 million de-identified pharmacy claims administered by Express Scripts during these periods,” according to the release.
In the analysis, specialty medications, including medications for HCV, accounted for 42% of all pharmacy spending among exchange plans, according to the release. Sovaldi (sofosbuvir, Gilead Sciences) and Harvoni (ledipasvir/sofosbuvir, Gilead Sciences) were the two most expensive specialty drugs for exchange plan members. Harvoni, which was approved by the FDA in October 2014, represented 6.4% of the total pharmacy spending among exchange plans.
“Plans that implemented Express Scripts hepatitis C value program can expect reduced spending in this class in 2015,” according to the report.
Also in the report, the analysis found that the spending rate for the HCV medications increased 96% in quarter 1 of 2015 compared with quarter 1 of 2014.
Spending for oral contraceptives increased from quarter 1 of 2014 to quarter 1 of 2015 by 29%. HIV, although the most common specialty condition, decreased 11% in quarter 1 of 2015 compared with quarter 1 of 2014, according to the release.
The report further stated that exchange plan costs increased by 16% per member per month compared with traditional health plans, largely due to the increased specialty drug spending among exchange plan enrollees.
“While it is encouraging to see data that suggests healthier Americans are enrolling in exchange plans, the research reminds us that many of these patients use this benefit to manage serious, chronic illnesses,” Julie Huppert, vice president of healthcare reform at Express Scripts, said in the release. “Exchange plans have an opportunity to make medications more affordable and accessible by more closely managing the benefit, encouraging the use of home delivery pharmacy and other proven clinical pharmacy programs, which can help boost medication adherence and foster better disease management.”
Express Scripts. Express Scripts provides first look at 2015 public exchange pharmacy trends. Available at: http://lab.express-scripts.com/. Accessed July 7, 2015.
Disclosure: Huppert reports being employed by Express Scripts.