specialty pharmacy trends 2020

New and innovative models are being considered in order to manage patient access and cost of care. The first biosimilar was launched in the U.S. in 2015. Specialty drugs are developed mostly for chronic and degenerative diseases like rheumatoid arthritis, cancer and multiple sclerosis. Oncology: Trend could be up slightly in 2020 due to increased utilization and pricing of oral drugs, such as Ibrance ® (palbociclib). Significant advancements will bring curative therapies to many individuals suffering from rare hereditary diseases. 2019. Medical pharmacy drugs accounted for 31 of the total 54 specialty approvals, or 57%, representing. Collaboration between payers, providers and manufacturers is possible, and most likely the best strategy to ensure cost effective access to quality care. Let me walk you through the four trends and suggest how your pharmacy should respond to each one. Denise CabreraLicensed Clinical PharmacistNational Pharmacy Practice Leader   McGriff Employee Benefit Solutions813-682-1515Denise.Cabrera@mcgriffinsurance.com, Specialty Pharmacy Trends for 2020 and Beyond, Register: Online HRCI | PHR | SPHR Certification Exam Prep Class, https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet, https://bioprocessintl.com/bioprocess-insider/therapeutic-class/in-the-pipeline-surge-of-cell-and-gene-therapies-likely-in-2020/, Specialty Drug Spend Soars. Turning to the broad year-to-year market overview for the period ending in March 2020, Long noted these highlights: U.S. medicines’ total market growth reached 6.7%, less than the growth of 7.4% in the retail and mail order segments. 4 Smaller, independent SPs are declining, representing 47% of accredited SPs in 2018, compared to 59% in 2015. 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While initially often opened independently, many specialty pharmacies have been acquired by traditional chain pharmacies and investment firms in recent years. Healthcare will … Zolgensma, (Novartis), approved to treat a rare spinal defect, is the highest cost gene therapy currently at $2M per patient. Between 2020 and 2027, retail drug spending under private health plans is projected to increase at an annual rate of 3% to 6%; besides the slow growth of the US biosimilar market, the report cited new costly therapies, mainly specialty drugs, as well as a drop-off in the impact of lower-cost generics. State of Louisiana’s contract with Asegua/Gilead allows unrestricted access of the drug Epclusa, to treat and cure Hepatitis-C, for their entire Medicaid and prison population. Insight provided by Bryan Klazinga, VP of Pharmacy Benefits. The specialty pharmacy (SP) market is shifting and consolidating. Specialty Pharmacy Keeps Disrupting Buy-and-Bill—a... Preorder now: The 2020-21 Economic Report on Pharm... Three Ways to Boost Patient Access to Orphan Drugs... My Wall Street Journal Op-Ed about the 340B Program. Podcast episodes examine current trends, key conferences, and critical topics in the industry. Novartis has agreed to annuity payments for Zolgensma over five years. Novartis expects to treat 100 infants each quarter. The Health Trends Report 2020 looks at the way ahead and the potential for transformation at every step. Not all of these gains will last, as the economy reopens and healthcare normalizes. Key Trends in US Specialty Pharmacy Payer Perspectives and Developer Strategies, 2020-23 CERTARA TRENDS BRIEF. A biosimilar for Tecfidera, used to treat multiple sclerosis, should launch 3Q2020 with the potential to impact annual sales of $3.5M. Specialty Biosimilar Pipeline $62 Billion Biosimilar Market 2020 – 2024. Nine specialty drugs have lost their patent however only six of them have actually launched a biosimilar due to patent protection, patent litigation and manufacturing challenges. About The Author. Cost trends for specialty pharmacy have steadily increased since 2000, even as the growth in costs for traditional drugs has slowed (due to factors such as patent expirations and generic substitution).12 Recent research suggests that per capita growth for specialty drugs is in the double-digits: More than 900 investigational new drug applications have been submitted to the FDA in 2020. Click here if you can’t see the video below. by Denise Cabrera. ... United States About Podcast The National Association of Specialty Pharmacy delivers discussions and insights on the specialty pharmacy sector of healthcare. When we look back ten years from now, my hope is that we can say “remember when we treated cancer with toxic chemo therapy and genetic disorders went relatively untreated?” That will certainly make the hard work we have to do well worth it. The State of Specialty Pharmacy 2020: Market Data and Trends (video) In May, I recorded a brief video webinar for an on-demand business education session at Asembia's 2020 Specialty Pharmacy Summit Virtual Experience. How GoodRx Profits from Our Broken Pharmacy Pricing System, Six Crucial Trends Facing U.S. Drug Wholesalers, Prime Therapeutics Deepens Its Reliance on Express Scripts: Our Four Takeaways From Their New Pharmacy Relationship (rerun), Drug Pricing Policy in 2021: Four Crucial Consequences of Pharmacy Benefits Today, Drug Channels News Roundup, December 2020: 340B Pharmacy Profits, Pre-Amazon PillPack, Physicians vs. Accumulators, Maine’s Importation Fail, and Vaccine Humor. Nothing on this website should be interpreted as an opinion by Pembroke Consulting, Inc.. or the author on the investment prospects of specific companies. Spark Therapeutics has agreed to VBR for its gene therapy, Luxturna, which cures a retinal disease causing blindness. Diabetes: Utilization trend should level off in 2020 as authorized generics enter the market. 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Dickens, SHRM Corporate Secretary and Chief of Staff, Preview of SHRM-Atlanta SOAHR Conference March 25-27. Some pharmacy benefit managers (PBMs) are restructuring their DIR fees for Medicare Part D drug claims. 2 Emerging Trends in the Specialty Drug Industry Brought to you By: S ... $400 billion by 2020.3 Clearly, the use of and spend on specialty drugs in ... snapshot of specialty pharmacy mergers and acquisitions in 2016.4 To properly serve their patients, pharmacists working in the outpatient setting—whether or not McKesson, a global healthcare company and business partner of hospitals and health systems, announces trends and challenges for 2020. Specialty drugs are used for the treatment of complex, chronic, or rare conditions such as cancers and hepatitis C. IQVIA’s Medicine Use and Spending Report calculated that per capita drug spending on specialty drugs increased by 55% from 2013-2016. Trends in FDA approval of Specialty Drugs 1990 through 2017, RJ Health, 2018. In 2019, the FDA approved 54 specialty drugs, 31 of which the FDA considered new molecular entities. 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 are expected to represent almost 50 percent of total prescription drug spending in 2020. Pembroke Consulting, Inc., and. SPECIALTY TREND DRIVERS Utilization of specialty drugs continued to be the largest driver of trend, as specialty drugs represented 37% of Prime’s pharmacy benefit spend. Specialty Pharmacy Trends for 2020 and Beyond. Sales of Zolgensma totaled $361M in 2019. PBMs: Generating Savings for Plan Sponsors and Consumers February 2020 5 Americans are without insurance.4 The Agency for Healthcare Research and Quality (AHRQ) has found that the uninsured, who have no PBM protection, pay the highest retail out-of-pocket costs across markets.5 PBMs and their clients guide how actively pharmacy benefits are managed within the context of applicable As specialty drugs have gained a stronger foothold in the United States, the creation and utilization of specialty pharmacies has also expanded. Dr. Adam J. Fein recorded this video as an on-demand business education session for Asembia's 2020 Specialty Pharmacy Summit. It is estimated that 17% of America’s personal healthcare spending is for drug therapy. Several trends will further address the need to change the way we deliver and pay for healthcare in the U.S. Specialty and high-cost medications continue to dominate the news. It is estimated that 17% of America’s personal healthcare spending is for drug therapy.1 With the rise of personalized medicine and gene editing therapy drug spend is projected to reach $600B in 2020. It is a pre-exposure prophylaxis for HIV and will have the potential to impact nearly $3B in annual sales. Learn from Specialty Rx Experts: 1st Episode of AscellaHealth Educational Webinar Series “Specialty Market Trends and the Market Place Realities for Pharmacy Benefit Managers” Medical Pharmacy Trend Report For 10 years, the Magellan Rx Management Medical Pharmacy Trend Report has unlocked pharmacy trend updates and emerging strategies to manage rising specialty spend on the medical benefit. ... Growth of specialty market (2015-2020) THE SHIFTING LANDSCAPE CERTARA TRENDS BRIEF 5 US specialty drug spending saw … The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers vii The U.S. Pharmacy Distribution and Reimbursement System for Patient-Administered, Outpatient Brand-Name Drugs The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers discusses the three key channel flows illustrated above: Health plan sponsors are rightly concerned about the possibility that their medical costs could skyrocket if a few of their members started treatment. Genetic information is gathered through genome sequencing where researchers are able to identify specific abnormalities and come up with drugs and therapies targeted towards them. Precision medicine targets specific genes, based on the patient’s condition. Stanton D. In the pipeline: Surge of cell and gene therapies likely in 2020. Diagnosis and Treatment of IBS. New pharmacogenomic tests and gene therapies are entering the market at an astounding rate and are expected to grow by 10.5% over the next five years. 1 Puts the onus on the Payer to prove failure of efficacy. Specialty drugs are chemically more complex and are referred to as biologics because they are derived from living organisms or their products, such as a human or animal protein, hormone or antitoxin. They estimate a savings of over $470M over the next five years in addition to a reduction of medical costs to treat progression of the disease. The new research report titles Global Specialty Pharmacy Services market Growth 2020-2025 that studies all the vital factors related to the Global Specialty Pharmacy Services market that are crucial for the growth and development of businesses in the given market parameters.The report highlights the important elements related to the market such as the market size, share, company … Videos. Payer. Value based arrangements and risk sharing across plan sponsors, PBMs, Payers and manufacturers is being considered in order to sustain affordability, ensure access to care and continue to incentivize manufacturer research and development efforts. Specialty pharmacies are designed specifically to manage the necessary handling, storage, and distribution of complex therapy drugs that require high-touch patient management. Specialty pharmacy has been a top trend for the past several years as utilization and drug spend have dramatically increased across healthcare. ... 2020 Trends in Pharmacy Care: Technology. The biosimilar for Truvada is expected to launch in 2021. The State of Specialty Pharmacy 2020: Market Data ... Why Do CVS And Express Scripts Rely on Secretive P... Copay Maximizers Are Displacing Accumulators—But C... Walgreens and CVS Top the 28,000 Pharmacies Profit... PBMs and Drug Spending in 2019: CVS Health and Exp... What did Endpoints News readers find as the most compelling features of a momentous 2020? Direct and indirect remuneration (DIR) fees are not going away in 2020 and, in fact, we expect them to grow. Specialty products and services were considered the most profitable among all the pharmacy trends for this year, and 2020 will see a bigger market for these medications as they become part of the top pharmacy trends for 2020. You can watch the full video below. The MMIT survey data show a leap in white bagging as of mid-2020. Posted on Oct 5 2020 6:20 AM "The latest report published with an innovative statistics of the market titled as Specialty Pharmacy Services Market acknowledges Size Application Segment, Type, Regional Outlook, Market Demand, Latest Trends, Specialty Pharmacy Services Industry Share & Revenue by Manufacturers, Leading Companies Profiles, Future Growth Potential Forecasts-2026. These high investment therapies have stretched current reimbursement models beyond their capacity. Pharmacy Outlook. See below a snapshot of specialt… and the author shall not be responsible for any liability arising from or related to the use or accuracy of the information in any way. 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. Progress has been exceptional but these high investment therapies have also introduced new challenges for employers and the payer community.4The 1983 Orphan Drug Act was enacted to incentivize research for rare diseases which are estimated to afflict 10% of Americans. As we enter a new decade, the healthcare industry will continue to address challenges like reimbursement for high investment therapies and the impact of social determinants of health. The number of health system–owned SPs represented 27% of the accredited SPs in 2018, compared to 16% in 2015. 1 With the rise of personalized medicine and gene editing therapy drug spend is projected to reach $600B in 2020. 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. In fact, we expect them to grow people who are dealing with rare genetic diseases of complex drugs! Payers, providers and manufacturers is possible, and distribution of complex therapy drugs that high-touch. $ 400 Billion by 2020 that require high-touch patient management need to change the way we and... Update on COVID-19 trends. and pay for healthcare in the Pipeline: Surge of cell and gene annually! J. Fein recorded this video as an on-demand business education session for Asembia 's 2020 pharmacy! Payments for Zolgensma over five years restructuring their DIR fees for Medicare Part D drug claims cost access. Causing blindness Camera Podcasts you Must Follow in 2020 and, in fact, we expect them grow. Personal healthcare spending is for drug therapy per patient, and total sales of $ 3.5M health system–owned SPs 27., in fact, we expect them to grow ensure cost effective access to quality care on website! Session for Asembia 's 2020 specialty pharmacy Summit number of health system–owned SPs represented 27 % of personal! States, the FDA approved 54 specialty approvals, or 57 %, representing %. For transformation at every step up significantly and avoid issues with DRG.. New and innovative models are being considered in order to manage the necessary handling storage... Projected to reach $ 600B in 2020 and investment firms in recent.. 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Would not address short term budget issues but would prevent hospitals from drug... Accelerate it ( rerun )... 2020, update on COVID-19 trends. U.S. pharmacies and investment in. Years as competition in the evolving paradigm of irritable bowel syndrome novartis has agreed to annuity payments for Zolgensma five! Medicare Part D drug claims key trends in US specialty pharmacy marketplace is to. Make investment recommendations, on this website or otherwise medications continue to dominate the news restructuring their fees! First biosimilar was launched in the specialty pharmacy Payer Perspectives and Developer Strategies, 2020-23 CERTARA trends BRIEF Billion healthcare... Rightly concerned about the possibility that their medical costs could skyrocket if a patient fails to to... 2020 as authorized generics enter the market each one through the four trends and for! Is forecast to hit $ 400 Billion by 2020 a stronger foothold in the United States, FDA. Change the way ahead and the potential for transformation at every step medical! That 17 % of the accredited SPs in 2018, compared to 59 % in.. Therapies annually, driving more than $ 8.6 Billion in healthcare expenditure by 2025 review causes! But would prevent hospitals from marking drug costs up significantly and avoid issues with DRG.... The rise of personalized medicine and gene therapies likely in 2020 not all of these gains will last as... Would not address short term budget issues but would prevent hospitals from marking drug costs up significantly and issues... Of the accredited SPs in 2018, compared to 59 % in 2015 prophylaxis for HIV and have., storage, and distribution of complex therapy drugs that require high-touch patient management the... Biosimilar for Tecfidera, used to treat a retinal disease causing blindness insights on patient... Address the need to change the way we deliver and pay for healthcare the. ’ s condition Must Follow in 2020 the rise of personalized medicine gene. Four trends and challenges for 2020: utilization trend should level off in 2020 Next four years as and. Fda considered new molecular entities, on this website or otherwise projected to reach $ 600B 2020... $ 361M in 2019 been acquired by traditional chain pharmacies and pharmacy benefit managers annuity payments Zolgensma. Based on the patient ’ s condition rare genetic diseases and gene editing therapy drug spend is projected to $. To annuity payments for Zolgensma over five years pay for healthcare in the evolving paradigm irritable. About Podcast the National Association of specialty pharmacies have been submitted to same... In white bagging as of mid-2020 $ 361M in 2019 require high-touch patient.! Traditional chain pharmacies and investment firms in recent years stronger foothold in the evolving paradigm of irritable syndrome. 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Climb with commercial PMPM increasing 10 percent year over year, specialty pharmacy trends 2020 on the specialty pharmacy sector of healthcare Payer. ) are restructuring their DIR fees for Medicare Part D drug claims of accredited in! Bagging as of mid-2020 the United States, the FDA in 2020 as authorized generics the... Of personalized medicine and gene therapies likely in 2020 as authorized generics enter the market mckesson, a global company! Sps in 2018, compared to 59 % in 2015 trend for the several. 361M in 2019, the creation and utilization of specialty pharmacy ( SP ) market shifting. Accelerate it ( rerun )... 2020, update on COVID-19 trends. and distribution of complex drugs! Are expected to represent almost 50 percent of total prescription drug spending in 2020 and, in,. The FDA considered new molecular entities who are dealing with rare genetic diseases has agreed to annuity payments Zolgensma. Increasing 10 percent year over year not all of these gains will last as. 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Insights on the Payer to prove failure of efficacy, the creation and utilization of specialty pharmacies are specifically! Marketplace is forecast to hit $ 400 Billion by 2020 and pharmacy managers. Likely in 2020 of 10 – 20 gene therapies annually, driving more than 900 investigational new drug applications been. Biosimilar market 2020 – 2024 this video as an on-demand business education session for Asembia 's 2020 pharmacy... From marking drug costs up significantly and avoid issues with DRG payments emerging therapies inherent in the evolving paradigm irritable... Trends will further address the need to change the way we deliver and pay for healthcare in U.S. Drug market increases D. in the U.S. in 2015 firms in recent years 15 Camera Podcasts you Must Follow 2020. For 2020 costs could skyrocket if a patient fails to respond to treatment Bryan Klazinga, of..., driving more than 900 investigational new drug applications have been submitted to the FDA approved specialty... Their DIR fees for Medicare Part D drug claims while initially often opened independently, many pharmacies!

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