The overall price of drugs has fallen, but some Americans' medication bills still continue to rise. Although 85 percent of prescriptions filled last year cost less than $5 out-of-pocket, medication for rare diseases has become more expensive. Health insurance is paying for decreasing amounts of specialty drug costs, putting a heavier financial burden on those who suffer from less-popular diseases. The rising cost of specialty drugs contributed to the $329.2 billion spent on health care last year. There are many contributing factors to this increase in specialty drug costs, and specialists believe the trend will continue.
A recent report by the IMS Institute for Healthcare Informatics released information on the total U.S spending on medicine in 2013. Also included in the report were many of the contributions and consequences of this figure. The amount spent on medication in 2013 was 3.2 percent higher than that spent in the previous year. According to The New York Times, more than half of prescriptions cost patients less than $5 in out-of-pocket costs, with 86 percent of persciptions filled with generic medicines. For 23 percent of patients, there was no out-of-pocket cost at all. This can be mostly attributed to the new health care law that makes contraceptive drugs free. The most shocking figures of the report revealed that only 2.3 percent of prescriptions accounted for 30 percent of all out-of-pocket costs. This is due largely in part to the high costs of specialty drugs.
The increasing cost of specialty drugs may be a result of the collapse of many blockbuster drugs in recent years. In combination with this and competition by cheaper generic versions, drug companies have now turned to treatment for smaller and more complex diseases in order to bring in revenue. In 2013, there were 36 new drugs debuted. This included the most new cancer treatments in more than 10 years. “The new drugs coming to market are more specialized, and more tailored to smaller populations of patients, which tends to make them more expensive because fewer people are ultimately going to take them,” Caroline F. Pearson, vice president at the health care consulting firm Avalere Health, explained in The Times.
In combination with the increasing prices of specialty drugs, consumers are expected to pay more of the total costs. Last year, 23 percent of employer-sponsored health plans placed specialty drugs in their own tier. This meant that consumers were asked to pay a percentage of the drug cost, rather than the traditional set co-payment. Compare these numbers with 2006, where only five percent of employer plans had this specialty tier. According to The Times, this trend will most likely continue.
The report also highlighted some good news for American health care. Last year saw an increase in the number of individuals who visited a doctor, went to a hospital, and filled out prescriptions. Visits to specialists increased by 4.9 percent, and patents filled an average of 12 prescriptions a year, an increase of two percent from the previous year.
This increased use of health care services and medicine is likely due to the improving economy. “When people are feeling less secure, they cut back on health care. When they are feeling more flush, they start to return to the doctor and the pharmacy in larger numbers,” Larry Levitt, senior vice president of the Kaiser Family Foundation, told The Times.
Another contributing factor to the increase in health care spending is the reduced impact of patent expires. According to a press release, patent expires in 2013 contributed to $19 billion in lower medicine spending, compared to $29 billion in the previous year.