Showing posts with label prescription. Show all posts
Showing posts with label prescription. Show all posts

Friday, April 30, 2010

U.S. prescription drug sales hit $300 bln in 2009

This article provides benchmarks for drug spend 2008/2009. Be aware that you can find different benchmarks depending on the source. For example, the IMS figures come from sterilized ambulatory prescription data, while AARP and the National Association of Chain Drug Stores (NACDS) often provide different information from other sources. It is a good practice to ask for the source of data before quoting the results.



(Reuters) - U.S. prescription drug sales climbed by 5.1 percent to $300.3 billion in 2009, easily outpacing the 1.8 percent growth rate seen in 2008, according to data collected by IMS Health.

HEALTH

While the growth rate was far stronger than that seen the previous two years, it still represents historically low levels, said IMS, a leading provider of prescription drug data.

Over the past 50 years, the U.S. prescription growth rate dipped below 5 percent only three times, including in 2007 and 2008.

"Despite the severity of the economic environment, the demand for prescription pharmaceuticals remained strong," Murray Aitken, senior vice president of IMS Healthcare Insight, said in an interview.

"Patients continued their therapies, perhaps more than many had expected, and as a result we saw an increase in spending, taking the market to $300 billion," Aitken added.

Helping to fuel the growth was a 7.5 percent rise in demand for specialty pharmaceuticals used to treat complex, chronic conditions that now make up 21 percent of U.S. market value.

Sales of targeted biotechnology medicines, such as Roche's cancer drugs Avastin and Herceptin, grew by 9 percent in 2009.

Prescriptions dispensed through retail channels, such as pharmacies, through mail-order and at long-term care facilities, grew 2.1 percent - twice as fast as in 2008 - to 3.9 billion prescriptions.

Tempering the total dollars spent on U.S. prescriptions was a rise in the use of cheaper generic medicines, which in 2009 accounted for 75 percent of all dispensed prescriptions, up from 57 percent five years earlier. Despite their relatively inexpensive cost, generics still accounted for $74 billion in 2009 sales.

The total number of generic prescriptions dispensed in the United States increased 5.9 percent in 2009, while those for branded drugs fell by 7.6 percent

The shift toward generics is likely to accelerate by 2012, when several major products, including the world's two biggest-selling medicines - the cholesterol fighter Lipitor and the blood clot preventer Plavix - face competition from cheap generics. Lipitor is sold by Pfizer Inc and Plavix by Bristol-Myers Squibb Co and Sanofi-Aventis.

"We still see that when a product goes generic almost all of the prescriptions, 90 percent or so, are dispensed in their generic form," Aitken said.

Antipsychotics remained the top-selling class of medicines in the United States with $14.6 billion in sales, about equal to 2008 revenue.

Acid reflux drugs, such as AstraZeneca's Nexium, were the second-biggest therapeutic class by sales at $13.6 billion, with prescriptions up 5 percent.

Lipid regulators, which include cholesterol and triglyceride lowering drugs, were still the largest class by prescriptions, growing 5 percent to 212 million prescriptions dispensed. But U.S. sales declined 10 percent to $13.6 billion as the majority of cholesterol fighters are now available as generics, pushing the class to third in sales.

Antidepressants ranked fourth in 2009, growing 3 percent to $9.9 billion, IMS said.

"The thing that surprised us compared with what we might have expected a year ago was how the overall demand held up during a year that in many other parts of the economy we saw declines in demand," Aitken said.

"The higher growth than the prior year we think is notable and underscores the resilience of pharmacotherapy in today's healthcare equation."



COMMENTS

Apr 01, 2010 2:54pm EDT

Consumers of health and life insurance should understand that prescriptions purchased at the drugstore could harm your chances of getting insurance coverage.

According to BusinessWeek, an untold number of people have been rejected for medical coverage for a reason they never could have guessed: Insurance companies are using huge, commercially available prescription databases to screen out applicants based on their drug purchases.

https://www.annualmedicalreport.com/prescription-analytics-corporate-databases-track-whats-in-your-medicine-cabinet/

Health experts, like Doctor Kate Atkinson of Amherst, worry that insurance companies make incorrect assumptions by analyzing prescription records, because many drugs have multiple uses. Dr. Atkinson told the Washington Post, “I had a patient on Amitriptyline for migraines and they were denied life insurance because it’s also an antidepressant. I had to explain it wasn’t being used for depression.” Another patient was on Prozac — not for depression, but for menopausal hot flashes. “I wrote an appeal letter, and they still wouldn’t give it to her.”

“When an insurer makes an online query about an applicant, Ingenix or Milliman’s servers scour the data and within minutes or less return reports to a central server at the company. The server aggregates the information going back as far as five years, including the drugs and dosages prescribed, dates filled and refilled, the therapeutic class and the name and address of the prescribing doctor. Then comes the analysis. One software tool provides insurers a “pharmacy risk score,” or a number that represents an “expected risk” for a group of people, such as 30- to 35-year-old women who have taken prescription drugs…Higher scores imply higher medical costs.”

Tuesday, January 19, 2010

Is Flat Fee A New Trend?

Payers understand that one of the major advantages of a PBM (Pharmacy Benefit Manager) is their pharmacy network. PBMs sign up pharmacies, approve and monitor pharmacy claims in real time, set up formularies, and send the pharmacies checks for prescriptions filled.

  • Most pharmacies expect to get paid for dispensing prescriptions based on a formula that is outlined in their network contract.
  • Most payers expect to pay their invoice for dispensed prescriptions based on the formula that they agreed upon in their contract.

    It is understandable that pharmacies may be paid a different price in one network. One would expect urban dispensers to compete for the network and drive the dispensing fee down. Conversely, a rural pharmacy (possibly the only drugstore in town) would probably get a higher price for filling a small community’s prescriptions.

    Networks also contain other dispensers such as mail order pharmacies, specialty products pharmacies, and preferential pharmacies. Each group would probably have a different contract and a different payment formula.

    What about government pharmacies that fill prescriptions in a non-government network? The VA (Veterans Administration) is such a network.

    Government pharmacies buy drugs at special government prices. Many prices are 50-75% below the community pharmacy cost.
    (The government doesn’t need to buy drugs from Canada because it already gets a very special low price.)
    The government, because of their buying advantage, is not supposed to compete with community pharmacy. In many cases, the government gives away prescriptions to the disadvantaged and has many programs to assist states in covering the medical needs of those that can not afford care.

    Based on the government’s goals and purpose in the health care system it is understandable that they would get a special low price on drugs. It is also understandable that the government can dispense drugs for a much lower price than can retail pharmacy. But what about the reverse? What if the government charges a payer more than retail pharmacy – in a flat fee system?

    One network (XYZ) that is of interest is with one PBM and the VA on the east coast. Instead of charging a low price for drugs, they are paid $51 for each prescription they fill no matter what the cost. How could this happen? More importantly, why did this happen? Community pharmacy is paid on a cost plus a dispensing fee formula and the VA on the east coast is paid on a flat fee formula?

    We called several VA pharmacies and tried to find out if they knew that they were being paid much more than retail pharmacies on each prescription and no one knew what we was talking about. When the PBM was asked we were told that this is what the VA demanded.

    Should community pharmacy ask for a flat fee too? Is this a new trend in contracting? And even more complicated, should the government give payers the advantage of their lower cost of drugs?

    Please let us know if you have seen any of these issues. We are interested in your comments and opinions.

  • Developed by Barry Pascal, PharmD, Pro Pharma Pharmacist