2019 Drug Trend Report

Lowest trend in 5 years, industry-leading performance

A couple stroll together on the beach
May 21, 2020
Executive Vice President, CVS Health and President, CVS Caremark

Our job is to be the best manager of our clients’ pharmacy benefit by eliminating wasteful spend, reducing inefficient spend, and encouraging impactful spend that can help reduce medical costs. In 2019, we stayed the course delivering historically low trend despite rising prescription utilization.

At 1.4 percent, overall trend in 2019 was the lowest in five years, despite increases in prescription utilization and ongoing manufacturer-driven price inflation. Trend for clients who opted for tighter management strategies was even lower and overall, 41 percent of our commercial clients had negative trend. Through smart formulary and utilization management strategies we mitigated the impact of price inflation, prioritized lower-cost and generic options when clinically appropriate, and delivered negative price growth for non-specialty drugs and very low price growth for specialty drugs. This enabled us to deliver low net trend and single-digit specialty trend for a broad cross-section of clients, covering more than 25 million commercially-insured lives.
overall 2019 trend
of clients had negative trend
Specialty treatments now comprise nearly half of all pharmacy spending and remain the key management challenge. New specialty drugs dominate the pipeline and, along with supplemental indications for existing products, spur utilization growth, which accounted for 80 percent of specialty trend in 2019. Despite these factors, with focused management, we helped our clients keep specialty trend in the single digits. Clients who opted for tighter management reduced trend even more.
2019 specialty trend
2019 specialty trend with tight management
Formulary and utilization management (UM) strategies remain the foundation of effective pharmacy benefit management. Our strategies enabled clients to ensure appropriate use and mitigate the impact of high-cost drugs that do not demonstrate a clear clinical benefit. In addition to negotiating discounts from manufacturers on behalf of our clients, we use industry-leading formulary strategies — including preferred placement and drug removals — to encourage use of lower-cost and clinically equivalent generic options when appropriate.
2019 client savings from template formulary and UM strategies
2019 client savings from prioritization of generics and biosimilars
Cost can be a barrier to adherence and can force tough decisions about whether or not to fill a prescription. Keeping prescriptions affordable for plan members continues to be a key priority. We helped keep member costs low with formulary designs that prioritize lower-cost products, and solutions such as $0 copay preventive drug lists and point-of-sale rebates, which enables clients to pass on all or a portion of the rebates we negotiate from manufacturers to members during the deductible phase. Member costs declined year-over-year.
decline in avg. member cost per 30-day supply since 2015
of members spent less than $100 OOP in 2019
Do you have questions about your plan’s drug trend? Ask Us
May 21, 2020
Executive Vice President, CVS Health and President, CVS Caremark

Adherence and health outcome results, savings projections and performance ratings are based on CVS Caremark data. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors. Client-specific modeling available upon request.

Savings will vary based upon a variety of factors including things such as plan design, demographics and programs implemented by the plan.

The source for data in this presentation is CVS Health Enterprise Analytics unless otherwise noted.