A latest research by the Blue Cross Blue Shield Association (BCBSA) and HealthCore Inc. indicates that per member specialty pharmacy spending increased 26% from the period of 2013 to 2014.
The report, “The Growth in Specialty Drug Spending from 2013 to 2014,” depicts a comprehensive, in-depth research of prices for both medical and pharmacy claims. Almost half of specialty drug spending is funded by each profit. Analyzing medical benefit data permits for a thorough analysis of changes in the price of medication administered at hospitals and other clinical atmospheres. For instance, more than 80% of cancer medication prices are billed through the medical benefit. Comparing specialty pharmacy spending in the year 2013 and 2014, this study discovered that:
Total prices of treatment increased across all specialty drug categories characterized in the study. Of the 26% cost increase for specialty drugs between the year of 2013 and 2014 for commercially-insured members, 15% can be attributed to higher prices for treatments. Utilization accounted for an 11% increase in specialty pharmacy spending.
“The recent, rapid increases in specialty drug prices are a concern for everyone — the public, medical experts, health care companies, employers of entire sizes and taxpayers who bear the price of prescription drugs offered by government programs like Medicare, Medicaid and those who get financial assistance to buy individual coverage,” stated Dr. Trent Haywood, chief medical officer for BCBSA. “To promote affordability and access to new innovative medicines, it is significant to have greater competition and choice to bring prices down for everyone, involving speeding up the approval of generic and biosimilar drugs. There also should be transparency regarding the pricing of prescription medicines with data about cost and a drug’s effectiveness made widely present to the public.”
This is the 7th research of the Blue Cross Blue Shield, The Health of America ReportSM series, collaboration between the Blue Cross Blue Shield Association and Blue Health Intelligence, which utilizes a market-leading claims database to disclose key trends and insights into health care affordability and approach to care. This report of Blue Cross Blue Shield Association was written by and also involves medical claims data from HealthCore Inc., a wholly-owned and independently operated health results subsidiary of Anthem, Inc.
* The report of Blue Cross Blue Shield Association covers the majority of Blue Cross and Blue Shield (BCBS) industries’ commercially insured and individual members across the country and nearly 70% of all BCBS membership or a sample size of almost 70.5 million BCBS members each year in the years of 2013 and 2014. It doesn’t involve members who get coverage through Medicare or Medicaid programs. All prices reported are the combined cost of payment by BCBS industries and by members (out of pocket). Costs don’t account for rebates gave by drug manufactures.
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