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Express Scripts Reveals What Really Drives Drug Spending—And Why the Government May Do No Better

Last week, Express Scripts released its 2016 Drug Trend Report for the commercial market. (Free download. Download the two separate documents titled “Executive Summary” and “Commercially Insured” for the full story.)

Kudos to Express Scripts for continuing to publish these insightful data. Too bad that its PBM peers have stopped releasing comparable data or devolved into publishing only the briefest of marketing pamphlets.

For 2016, drug trend—the year-over-year change in spending—was a mere 3.8% for Express Scripts’ commercial plan sponsor customers. The Express Scripts data also highlight how drug prices were only part of the reason behind moderating drug spend. Contrary to the public rhetoric, increased utilization was a bigger influence than higher prices for both specialty and traditional drugs.

Tough benefit management enabled one-third of plan sponsors to lower spending from 2015 to 2016. Will Medicare and Medicaid really be willing to limit access to medicines and pharmacies? I wonder how many Americans would say “Be Mine” to aggressive utilization management tactics.
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