Understanding Prescription Drug Pricing Trends



In 2019, the United States spent nearly $370 billion on prescription drugs, keeping trend with significant increases year over year. Although prescription drug spending has historically been a small proportion of national health care costs compared to hospital and physician services, it has grown rapidly in recent years—comprising about 10% of national health care spending.


Below are the two major factors contributing to the rise of prescription drug costs:


  • Influx of specialty drugs—Specialty medications account for a smaller portion of U.S. prescriptions than non-specialty drugs, yet they command nearly half of the pharmaceutical market. In 2021, experts predict an 11.5% increase in specialty drug prices, compared to a 2.8% rise in non-specialty drug prices. These manufacturer price increases are often cited by insurers as reasons for rising insurance premiums.

  • Price inflation—According to a Segal report, 40% of new products recently launched by drug manufacturers were specialty medications. These drugs are now being pushed at a higher rate than non-specialty drugs, contributing to price inflation. Specialty drug utilization increased by nearly 6% in 2020, whereas non-specialty drug usage remained relatively the same. And there is little recourse for anyone seeking an alternative to these specialty drugs.

Yet, despite these trends, there are cost-cutting strategies available to employers. These include managing drug usage, utilizing rebates and educating employees.

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