Blue Cross Blue Shield Association Analyzes the Increasing Prices of Specialty Pharmacy

A latest research by the Blue Cross Blue Shield Association (BCBSA) and HealthCore Inc. indicates that per member specialty pharmacy spending increased 26% from the period of 2013 to 2014.

The report, "The Growth in Specialty Drug Spending from 2013 to 2014," depicts a comprehensive, in-depth research of prices for both medical and pharmacy claims. Almost half of specialty drug spending is funded by each profit. Analyzing medical benefit data permits for a thorough analysis of changes in the price of medication administered at hospitals and other clinical atmospheres. For instance, more than 80% of cancer medication prices are billed through the medical benefit. Comparing specialty pharmacy spending in the year 2013 and 2014, this study discovered that:

• There was an $87 yearly annual per member increase in specialty pharmacy spending from the period of 2013 to 2014.


• The increasing prices of specialty drug treatments were the primary driver of the growth in spending. Treatment prices involve the price and selection of drugs. Increased utilization had a smaller impact on the progress in spending.


• In the year 2014, yearly specialty drug spending was 17% higher per member in the individual market in contrast to the employer market.  While price of treatment was similar between employer-based and individual members, there were differences in utilization amounts by condition. Utilization was importantly higher for individual members for cancer, human immunodeficiency virus and hepatitis, but moderately lower for inflammatory conditions (like rheumatoid arthritis) or multiple sclerosis.