April 6, 2017

Prime releases 2017 Drug Trend Reports

Prime is creating partnerships and programs that will reshape the PBM industry. These reports illustrate the powerful results that this work can generate.

Today Prime released spring 2017 drug trend reports for three lines of business: commercial, Medicaid, and Medicare Part D. Drug trend—the percent change in prescription medicine expenditures year over year—is one of the ways that pharmacy benefit managers (PBMs) assess and communicate their effectiveness in helping clients manage spending.

“Prime is committed to managing total drug cost, and nothing more clearly illustrates that commitment than these drug trend results,” said Jim DuCharme, Prime’s president and CEO. “And these reports reflect more than just success in managing trend for our clients. They represent the hard work and dedication of our team here at Prime plus the power of our collaboration with our clients and partners.”

The reports provide detail on the drug categories, drugs and other forces that helped shape trend in each line of business. Highlights of Prime’s spring 2017 drug trend reports include:

  • An overall 2016 commercial trend of 2.5%, an industry leading figure based on commercial trend reports released to date.
  • A negative trend in Medicare Part D of -0.7% in 2016, driven by negative utilization and 0% growth in unit cost.
  • A competitive overall trend of 6.9% in Medicaid in 2016; Prime’s average Medicaid cost-per-script was 19% lower than the national Medicaid average.

Shedding light on spending patterns

As a group, the reports also illustrate common prescription drug spending patterns among Prime’s clients:

  • In each line of business, the achievement of nearly flat or negative trend in traditional drugs helped to offset higher trends for specialty medications. Specialty medications as a group remain the most significant driver of trend overall.
  • Trends for traditional versus specialty drugs do not suggest that traditional drugs can be ignored. Diabetes drugs accounted for highest percentage of spend across Prime’s Commercial, Medicare D, and Medicaid clients. 
  • Aggressive management strategies helped to mitigate trend forces in 2016. Strategies included formulary, rebates, network management, price protection, and drug management. (Not all areas applicable to all lines of business. See reports for additional detail.)

Going above and beyond

In addition to trends and trend drivers, the reports provide examples of client savings in 2016 and highlight some of the powerful tools that Prime is using to effectively control drug costs. 

It’s our goal to help clients manage total drug costs – not just those on the pharmacy benefit. In 2016, Prime’s ability to integrate medical and pharmacy fueled medical cost savings of more than $350M through medical cost avoidance/adherence across all three lines of business.

Right now, Prime is creating partnerships and programs that will reshape the PBM industry. These reports illustrate the powerful results that this work can generate. As we move forward, Prime will continue to be relentless in aggressively managing trend while helping members get the medicine they need to feel better and live well.