A biosimilar for Tecfidera, used to treat multiple sclerosis, should launch 3Q2020 with the potential to impact annual sales of $3.5M. Total trend could rise slightly, reflecting higher drug prices, as insulins are considered biologics from March 2020. Changing DIR fee structure. do not make investment recommendations, on this website or otherwise. High investment therapies have stretched current reimbursement models beyond their capacity. Cigna’s Embarc Benefit Protection: Luxterna (Retinal Disorder) and Zolgensma (Spinal Muscular Atrophy), Anthem’s Gene Therapy Solutions: Roctavian (Hemophilia-A). Health plan sponsors are rightly concerned about the possibility that their medical costs could skyrocket if a few of their members started treatment. Hereâs a look at eight trends that experts expect will shape the industry next year: Continued shift to value-based care. Specialty drugs are used for the treatment of complex, chronic, or rare conditions such as cancers and hepatitis C. IQVIAâs Medicine Use and Spending Report calculated that per capita drug spending on specialty drugs increased by 55% from 2013-2016. Cancer (oral) and autoimmune treatments were the most influential drug categories in driving higher trend for all lines of business with trends in the double digits. It would not address short term budget issues but would prevent hospitals from marking drug costs up significantly and avoid issues with DRG payments. Pembroke Consulting, Inc., and. Collaboration between payers, providers and manufacturers is possible, and most likely the best strategy to ensure cost effective access to quality care. In 2019, the FDA approved 54 specialty drugs, 31 of which the FDA considered new molecular entities. Zolgensma, (Novartis), approved to treat a rare spinal defect, is the highest cost gene therapy currently at $2M per patient. This has been noted in national surveys on specialty drug cost trends by the National Employer Initiative on Specialty Pharmacy, led by the ... Planning a Specialty Drug Strategy Through 2020 . 2019. ... Growth of specialty market (2015-2020) THE SHIFTING LANDSCAPE CERTARA TRENDS BRIEF 5 US specialty drug spending saw â¦ Diagnosis and Treatment of IBS. THE SHIFTING LANDSCAPE ACCESS TRENDS IN SPECIALTY PHARMACY 2020-23 7 US specialty drug spending saw a modest annual growth of 3%, from 44.7% in 2018 to 47.7% in 2019 per ESI.10 On the basis of non-discounted spending, specialty growth has been outpacing traditional product growth, with a 10% to 0.3% dollar volume increase, per IQVIA. The first biosimilar was launched in the U.S. in 2015. See below a snapshot of specialtâ¦ 1 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. ... 2020 Trends in Pharmacy Care: Technology. Here are six developments we believe are worth watching and the ways that action today can help people and communities across the United States on their path to better health. Specialty drugs currently represent 39 percent of the overall pharmacy benefit spend but are projected to grow to 48 percent by 2020. Significant advancements will bring curative therapies to many individuals suffering from rare hereditary diseases. Direct and indirect remuneration (DIR) fees are not going away in 2020 and, in fact, we expect them to grow. Specialty drugs are developed mostly for chronic and degenerative diseases like rheumatoid arthritis, cancer and multiple sclerosis. 4 Smaller, independent SPs are declining, representing 47% of accredited SPs in 2018, compared to 59% in 2015. increasingly innovative strategies. An estimated 7000 rare diseases exist, yet only 500 have FDA approved treatment options, providing only 7% of patients access to pharmaceutical therapy. 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