2009 Drug Trend Insights - Prime Therapeutics

Strategic approach to Pharmacy trendsFocus Drug TrendsDrug utilization increased in allFocus categories except respiratoryconditions. Despite increased use,the overall PMPM trend for Focusdrugs was negative, the resultof a strong shift toward genericmedications.Figure 20 highlights PMPM trendand the key drivers of trend in keyFocus drug categories:Fig 20 focus Drugs: Category Trends InflationUtilization10%Drug Mix8.1Total PMPM8%6%4%2%0%-2%-4%-6%-8%-10%High cholesterol-5.6DiabetesHigh blood pressure-7.7Depression-3.2Respiratory3.0+ High cholesterolTrend was negative as genericdrugs simvastatin and pravastatingained market share and overallgeneric prices in this categorydecreased. Utilization is expectedto increase as the incidence ofdiabetes increases and studiesvalidate the value of treatingmore of the population withcholesterol-lowering drugs.+ DiabetesWith the highest utilization andtrend of 8.1 percent, diabetesis one of the fastest-growingtherapeutic categories. A rapidlyrising rate of diagnosis andincreasing use of diabetes drugs —especially among adolescents —drove utilization. 38, 39 New brandproducts and increasing priceshave contributed to high drugtrend. Generic savings to offsetincreasing utilization and costshave been limited by a lack ofsignificant generic launches.There are currently 183 medicinesin development to treat diabetesand related conditions. 40 Expectdiabetes trend to keep rising asnew products are approved andthe rate of diagnosis continuesto increase.+ High blood pressureContinued adoption of genericalternatives for Toprol ® , Norvasc ® ,and Spectrum ® , all introduced inmid-to-late 2007, helped increasethe generic fill rate and decreasespend. As obesity and metabolicsyndrome become increasinglycommon, expect utilizationto increase.+ DepressionRecurrent depression commonlyrequires long-term, continuoustreatment. As a result, antidepressantutilization seldom changesrapidly, as was seen in 2008.A negligible change in utilization,combined with decreasing genericprices and increasing generic use,drove trend down 3.2 percent.Utilization may increase as aresult of increased stress andeconomic malaise, but continuedgeneric price decreases andmarket share gains are likely tocontinue to drive costs down.+ RespiratoryCosts increased and utilizationdecreased as a result of the FDAmandatedwithdrawal of genericalbuterol inhalers containingchlorofluorocarbons (CFCs).Respiratory spending is expectedto increase in 2009 as memberswith existing supplies of CFCinhalers move to the replacementhydrofluoroalkane (HFA)inhalers. The cost for an HFAinhaler ranges from two to sixtimes that of a CFC inhaler.© Prime Therapeutics 2009 Drug Trend Insights39