Diabetes Drugs Are Now the Top Driver In Drug Spending Growth, Says Report


By: Patrick Totty

Diabetes treatments are now the leading driver of prescription drug spending growth, displacing lipid-lowering drugs, which tumbled in price after a reign of 10 years in the top position. Generic drugs are cutting the cost of treating high cholesterol.

That’s the conclusion of Medco Health Solutions, Inc., a pharmacy benefit management company, in its just released “2008 Drug Trend Report,” a comprehensive analysis of prescription drug spending and utilization.

The report shows that despite continued growth in the use of cholesterol drugs, spending fell 8.5 percent in 2007 as usage of lower-cost generic versions of Pravachol and Zocor expanded in the marketplace. As a result, lipid-lowering medications experienced the greatest spending decline of all drug categories.

Meanwhile, spending on diabetes drugs increased 12 percent due to shifts toward higher-cost treatments, brand-name drug price inflation, and moderate growth in the number of patients receiving treatment.

A Move to Newer Diabetes Drugs

Although spending on diabetes medications increased substantially, use of the drugs increased by only 2.3 percent in 2007. The discrepancy is explained by the fact that the cost of diabetes treatments rose sharply as patients shifted to newer drugs. These recently introduced medications have advantages over older drugs because they are faster-acting and help patients better maintain consistent blood sugar levels to prevent complications.

A sharp drop in Avandia use due to safety concerns, the withdrawal from the market of an inhalable form of insulin, and declining unit costs for many generic versions of diabetes drugs were not enough to offset the trend toward higher-cost treatments.

“The diabetes epidemic and the introduction of new products are reshaping prescription spending patterns,” says Medco Chief Medical Officer Robert S. Epstein, MD. “The number of people diagnosed with diabetes is increasing by about a million patients per year, meaning more people need complex drug therapies to control their blood sugar.”

Two- or three-drug combinations are frequently being used to reduce the complications associated with diabetes, which affects about 21 million Americans. However, only 7 percent of patients with the disorder achieve target goals for blood glucose, cholesterol and blood pressure.

For a decade, cholesterol drugs were the largest driver of “drug trend” –a measure of spending growth for pharmacy benefit plans. These medications still account for a sizable 10.8 percent of all prescription costs, with utilization rising 5.9 percent last year as new clinical guidelines expanded the population that can benefit from these treatments.



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