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BCBS report finds specialty, branded drug prices on rise

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According to Horizon Blue Cross Blue Shield of New Jersey, prescription costs overall account for 29 percent on average of all the provider's total health care spending.
According to Horizon Blue Cross Blue Shield of New Jersey, prescription costs overall account for 29 percent on average of all the provider's total health care spending. - ()

Horizon Blue Cross Blue Shield of New Jersey reported spending on branded specialty drugs — those used to treat complex, chronic health conditions that can require special handling, administration or monitoring — increased by 62.3 percent between 2013 and 2017.

According to a BCBSNJ statement, although specialty drugs represent between 4 percent and 6 percent of prescriptions issued for branded drugs, they account for between 32 percent and 44 percent of the total spend on branded drugs. 

Prescription costs overall now account for 29 percent on average of Horizon’s total health care spending and are rising faster than any other component of claims (physician services, inpatient, outpatient, prescriptions), driven by the substantial increase in spending on these branded specialty drugs, according to BCBSNJ.

The findings are consistent with data found in the “Health of America Report” on prescription drug costs, released Wednesday by the Blue Cross Blue Shield Association. The Association found that among commercially insured members of Blue plans nationally, branded specialty drugs made up 3 percent of branded drug prescriptions filled, but accounted for 34 percent of total branded drug spending.

Allen Karp, Horizon’s executive vice president for health care and transformation management, said stakeholders have to come together to find a better way to pay for drugs that cost tens of thousands of dollars a month or hundreds of thousands of dollars for a course of treatment.

“Patients can play a critical role in controlling drug costs by asking their doctor or pharmacist whether generic or other lower-cost drugs are available when getting a new prescription. For the overwhelming majority of prescriptions written, a lower-cost alternative is available,” Karp said.

A Blue Cross Blue Shield Association report reveals branded drug prices also continue to rise.

The report states prescription drug spending among branded specialty and patent-protected drugs continues to outpace generic drugs by $79.5 billion. At more than $100 billion, prescription drugs represent more than 20 percent of overall health care spending for BCBS commercially insured members.

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Anthony Vecchione

Anthony Vecchione covers health care for NJBIZ. You can contact him at: Avecchione@njbiz.com.

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