Spend and trend rise in 2022 forecasted to continue

Pharmaceutical Strategies Group (PSG), an EPIC company, is pleased to announce the release of its proprietary Artemetrx^® State of Specialty Spend and Trend report, sponsored by Walmart. The seventh annual report uses integrated pharmacy and medical claims data to provide a holistic view of specialty drug spend and trend. First published in 2017, this report is the sole comprehensive analysis of specialty drug spending, powered by the industry’s leading integrated dataset through Artemetrx.

Specialty drug trend continued to be driven primarily by claim utilization, accounting for nearly three-quarters of the overall 14.1% gross trend. However, cost per claim played a larger role in specialty trend than has been observed in recent history. “Integrated specialty trend, net of rebates, rose to 12.5% in 2022. An increase of 3.6% over 2021, rising specialty drugs costs and increasing utilization is impacting payers despite higher manufacturer rebates,” commented Libby Johnson, Senior Vice President & Chief Data Analytics Officer of PSG. The number of members taking specialty drugs continued to rise (4% of members took at least one specialty drug), while the average number of claims per person remained steady.

The top categories for specialty drug spend remained unchanged over past years, with inflammatory, oncology, and multiple sclerosis leading the way. For certain market baskets, overall prices declined as innovator brands and biosimilars competed for market share. The shift of spend from the medical benefit to the pharmacy benefit (which now represents 56.3% of specialty spend) observed in previous years continued, allowing for the maximization of rebates and a focus on utilization management. Rebates had a notable impact on average cost per claim, particularly in the pharmacy benefit channel.

“Walmart is a people-led company who puts the customer and patient first to deliver quality care and medications they need. Our Specialty pharmacy practice is focused on delivering cost-effective medications to help patients manage their complex conditions,” said Aleata Postell, Senior Director of Walmart Specialty Pharmacy. “Walmart plans to use the details in the Artemetrx report to inform our approach in delivering on programs and solutions that are driving value for our customers in both cost and services.”

The 2023 State of Specialty Spend and Trend report reflects PSG’s continued legacy of dedicated client advocacy, offering perspectives on how payers and plan sponsors can transform insights into opportunities. It provides a forecasted trend, which considers new biosimilars and therapies, as well as expanded indications. It also offers clinical perspectives on trending topics based on data derived from PSG’s Artemetrx system.

Follow this link to access the full report: www.psgconsults.com/2023spend-and-trend

About Artemetrx^®

Artemetrx is a proprietary SaaS platform developed by Pharmaceutical Strategies Group, an EPIC company. As a revolutionary technology solution integrating pharmacy and medical claims data for specialty drug cost management, Artemetrx provides market-leading specialty drug insights to payers. It delivers unparalleled intelligence and line-of-sight into serious challenges perpetuating out-of-control drug costs and compromised patient outcomes. PSG’s innovative drug management solutions, including Artemetrx, deliver actionable insights with exceptional financial and clinical value. PSG functions as a strategic partner through industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year. https://www.psgconsults.com/solutions/data-analytics

About Walmart

Walmart Inc. (NYSE: WMT) is a people-led, tech-powered omnichannel retailer helping people save money and live better - anytime and anywhere - in stores, online, and through their mobile devices. Each week, approximately 240 million customers and members visit more than 10,500 stores and numerous eCommerce websites in 20 countries. With fiscal year 2023 revenue of $611 billion, Walmart employs approximately 2.1 million associates worldwide. Walmart continues to be a leader in sustainability, corporate philanthropy, and employment opportunity. Additional information about Walmart can be found by visiting corporate.walmart.com, facebook.com/walmart, twitter.com/walmart, and linkedin.com/company/walmart.

Walmart Health & Wellness consists of more than 65,000 patient-care obsessed associates in more than 4,600 pharmacies that carry Specialty Accreditation with ACHC and more than 2,800 Vision Centers. Walmart Health operates 40 health centers and telehealth services in 50 states. We believe in bringing live better to life by delivering accessible, convenient and affordable care to the communities we serve.

About Walmart’s Specialty Pharmacy

Walmart’s Health & Wellness priority is to bring live better to life through patient-care obsessed associates who build relationships in their communities. Our Specialty Pharmacy team in Orlando focuses on high touch specialty care with 220+ associates made up of pharmacists, technicians, nurses, community health workers and patient care coordinators. Across the country, we have more than 110 pharmacy locations identified as community specialty pharmacy locations, and more than 1400 of our pharmacy associates have gone through specialized training to support specialty conditions such as HIV, with plans to expand our clinical excellence in more conditions and locations.

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