2017 Drug Trend: Containing Costs for Payors and Members

Pharmacy benefit management kept drug price growth nearly flat, improved adherence and reduced member out-of-pocket cost in 2017

VIDEO (3:35)
April 13, 2018
Executive Vice President and Chief Operating Officer, CVS Health

Containing cost is payors’ number one priority, and drug price growth in particular continues to be a primary challenge. While the rate of inflation slowed somewhat in 2017, brand drug prices continued to grow 50 percent faster than any other health care expense. Despite this growth, pharmacy benefit management (PBM) strategies kept drug price growth nearly flat for CVS Health payor clients, increasing by only 0.2 percent. The PBM utilized competition among manufacturers, offered plan designs that promoted generics first, and carefully managed utilization to help payors keep the pharmacy benefit affordable.

Member out-of-pocket costs declined in 2017, and nearly nine out of 10 members spent less than $300 on their prescriptions over the course of the year. Only a small percentage of members paid over $1,000 a year. Many of these high-cost members had high deductible health plans or used specialty medications.

Prescription affordability helped plan members adhere to their prescribed therapies. Utilization grew by 1.7 percent, and the number of optimally adherent members increased in key categories such as hypertension and diabetes. Price growth of 0.2 percent combined with utilization growth of 1.7 percent resulted in an overall prescription trend of 1.9 percent for commercial clients. Overall trend was the lowest in five years, while adherence levels were the highest in seven years. 

View more 2018 Forum highlights here.
 

Could your plan more effectively maximize generic utilization and control brand price growth? Ask Us
VIDEO (3:35)
April 13, 2018
Executive Vice President and Chief Operating Officer, CVS Health

Explore Programs

Cost Management

Controlling costs is most payors’ primary concern. Our market-leading solutions help clients get ahead of trend drivers and achieve lowest net cost.

Formulary Management

A comprehensive formulary strategy is foundational to mitigating the impact of escalating drug prices, and the introduction of new high-cost therapies.

Adherence

Investing in adherence helps reduce overall health care costs and drive better health outcomes.

Adherence results may vary based upon a variety of factors such as plan design, demographics and programs adopted by the plan. Client-specific modeling available upon request.

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