The pharmacy trend continues to increase year over year, but the growth rate of spend has decreased compared to only a few years ago. The main driver of trend, however, continues to be specialty drugs. Specialty net trend is around 10% for most commercial clients and has maintained this trend for the past few years. This is mostly due to an increase in specialty utilization and cost. Specifically, within specialty, drugs to treat inflammatory diseases and cancer continue to increase year over year and lead pharmacy trend.

Pharmacy Benefit Trend - What to Expect

Although, as specialty continues to increase, traditional drugs have experienced a decrease in trend which has kept overall net trend in the low single digits at most of the major PBMs. For example, in the commercial space:

  • CVS Health reported a net overall trend for 2019 at 1.4%
  • Express Scripts reported a net overall trend for 2019 at 2.3%
  • Prime Therapeutics report net overall trend for 2019 at 4.7%

We anticipate this type of overall trend to continue in the coming year as the market is not poised for significant changes. Additionally, plans are continuously looking to reduce pharmacy costs through new cost-saving measures which has contributed to the single-digit trend.

In the end, what matters is how has your pharmacy trend been over the past few years, and are you implementing the right strategies to drive down costs?