Drug spending surged 13% last year, with pricey hep C meds leading the charge

Express Scripts CMO Steve Miller

U.S. prescription drug spending shot up 13.1% last year, according to a new report from Express Scripts ($ESRX). And the vocal price critic says it knows just who's to blame.

The pharmacy benefits manager pinned the leap on a new group of ultrapricey hepatitis C meds, led by Gilead's ($GILD) Sovaldi and Harvoni. Those treatments helped specialty drugs--which account for only 1% of all prescriptions countrywide--put up 31.8% of 2014's overall drug spend. They also took hep C spending up by 742.6% from 2013.

The numbers apply to commercially insured patients, where spending per member per year amounted to $979.96 in 2014. Of that amount, $668.75 went to pay for traditional meds, while the rest--$311.11--paid for specialty drugs. More patients used specialty meds in 2014 compared with the previous year, the report says, but most of the increase came from higher prices. Price-wise, mainstream drugs went up 6.5%, the PBM says. Specialty drug prices leapt by 25.2%.

Express Scripts already has a plan in motion to change that going forward, though. After speaking out multiple times against the Gilead duo's hefty price tags, it struck an exclusive pact with AbbVie ($ABBV) to provide its rival Viekira Pak at a hefty discount. That move, shortly after Viekira Pak's approval, spawned a pricing war, with Gilead inking a few agreements of its own--including one with Express Scripts' main competitor, CVS Health ($CVS).

The way Express Scripts sees it, its move in the hep C arena will save its clients more than $1 billion in 2015--and it's encouraging its peers to follow suit. The new spending report only serves to bolster that case, Express Scripts said.

"These findings demonstrate the need for plans to take decisive action and more closely manage the pharmacy benefit to ensure all patients are able to achieve the best possible health outcomes at a price our country can afford," it wrote.

That doesn't just apply to hepatitis C. The company's CMO, Steve Miller, has made noise about bringing the same tactics to the up-and-coming PCSK9 field, as well as to cancer meds with lofty sticker prices.

But at least one cancer drugmaker isn't worried about Miller raining on its parade. As AbbVie CEO Richard Gonzalez, who last week agreed to shell out $21 billion on Imbruvica-maker Pharmacyclics ($PCYC), recently told Bloomberg, "Oncology is a different ballgame. You're talking about life and death; … it is not something you want to randomly start to manage in a way that would create risk for those patients."

- read more on Express Scripts' blog
- see the PBM's release
- listen to FierceBiotech Radio's newest episode with Steve Miller

Special Reports: The new drug approvals of 2014 - Harvoni - Viekira Pak | The most influential people in biopharma today - 2014 - Steve Miller - Express Scripts | The top 10 most expensive drugs of 2013

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