Drug costs under control while zero copay models thrive

April 16, 2014

Women saved $483 million in 2013 on contraceptives, or $22.44 per fill

In total dollars, spending on drugs reached $329.2 billion in 2013, an increase of 3.2%, which is noteworthy because the previous year saw a decrease in actual-dollar spending of 1%. However, growth over the past decade remains modest overall, according to a new report by the IMS Institute for Healthcare Informatics.

“Not surprisingly, the IMS study reveals a modest upward fluctuation in prescription drug costs this past year due primarily to growth in specialty drug usage, increases in manufacturer pricing and a diminished introduction of new generic entities to market,” says David Calabrese vice president and chief pharmacy officer for Catamaran, and MHE editorial advisor.

According to the report, little has changed in the dynamics of pharmacy spending, but more importantly, elements of long-term savings such as availability of generics and utilization management have a foothold.

One of the effects of the Affordable Care Act-specifically the mandate that FDA-approved contraceptive therapies be covered with no patient cost starting in 2013-is clear in the data. Women saved $483 million in 2013 on such medicines, or $22.44 per fill. Prescriptions for zero-copay contraceptives increased by 24.4 million from 2012 to 2013 as a result of ACA. A year ago, the rate of increase in women with no-cost contraceptives was 14%, compared to the current increase of 56%.

The commercially insured filled 207 million prescriptions with no copay in 2013, an increase of 44.9 million prescriptions.

Other therapy classes with increasing use of zero-copay models in 2013 include:

Antihypertensives-+2.8 million fills

Mental health-+2 million fills

Cholesterol-+1.5 million fills

Respiratory-+1.4 million fills