Specialty drug spend and trend continue upward momentum with little sign of slowing

Pharmaceutical Strategies Group (“PSG”), an EPIC company, releases its proprietary Artemetrx^® State of Specialty Spend and Trend report, sponsored by Walmart Specialty Pharmacy. In its eighth year, the 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.

The 2024 report found that despite downward pressure by biosimilars and generic specialty drugs, overall specialty drug spend and trend increased in the past year. The 14% trend represented an increase from the previous year but fell within the range of 10-15% consistently seen in the years of this report’s history. The report also revealed that while claim utilization continues to be the leading driver of specialty drug trend, cost per claim is now playing a substantial role as well. Another key finding was that the population of specialty drug utilizers continues to grow.

“One important takeaway from this report was that the percentage of members who use specialty drugs continues to rise with no signs of leveling off,” said Renee Rayburg, RPh, VP of Clinical Strategy at PSG. “There are also a handful of external factors influencing changes like more high-cost therapies entering the market, an influx of FDA approvals for branded specialty drugs, and shifts between the medical benefit and pharmacy benefit channels. From our standpoint, there are more variables for plan sponsors and payers to factor into decisions than ever before.”

Biosimilars are continuing to gain traction in the U.S. market, with notably large increases in the market share of the biosimilars for Lucentis and Remicade. Meanwhile, Humira remains the top specialty drug by spend, though Skyrizi rose from sixth in 2022 to third in 2023.

“The trends we are seeing aren’t surprising as much as they are affirming the market shifts we’ve been observing in real time. The PSG team has made considerable strides to stay ahead and account for the market influencers that this year’s report showed,” added Mike Lonergan, RPh, President of PSG.

“Walmart Specialty Pharmacy continues its journey toward improving health outcomes for all, and it starts with ensuring better access to affordable and convenient care,” said Aleata Postell, Group Director of Walmart Specialty Pharmacy. “We are a people-led, omnichannel care provider that remains committed to the communities we serve. The results from this report will further strengthen our ability to innovate and shape the way we prioritize value for our patients and customers.

The 2024 Artemetrx 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 for existing drugs. It also offers clinical perspectives on trending topics such as cell and gene therapies and drugs for Alzheimer’s Disease based on data derived from PSG’s Artemetrx platform.

Download the Artemetrx State of Specialty Spend and Trend report and register for the webinar reviewing the key findings here.

About Pharmaceutical Strategies Group (PSG)

Pharmaceutical Strategies Group, an EPIC company, relentlessly advocates for clients as they navigate complex and ever-changing drug cost management challenges. PSG is an independent consultant, empowering healthcare payers to manage their pharmacy program better. As a strategic partner, PSG helps clients by providing industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year. www.psgconsults.com

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 255 million customers and members visit more than 10,500 stores and numerous eCommerce websites in 19 countries. With fiscal year 2024 revenue of $648 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, on Facebook at facebook.com/walmart, on X (formerly known as Twitter) at twitter.com/walmart, and on LinkedIn at linkedin.com/company/walmart.

View source version on businesswire.com: https://www.businesswire.com/news/home/20240725225889/en/