Drug Trend Comparisons

September 20, 2008 by George Van Antwerp 2 Comments

Here are a few comparisons from the Drug Trend Reports published by some of the largest PBMs. There is no industry standard on definitions and what is included so I did my best to pick a couple of comparative metrics. (Note: In case you are unfamiliar with these reports, they are summaries of 2007.)

Overall Trend

Specialty Trend

Managed Trend

Generic Dispensing Rate

Mail Order (90-day)
CVS / Caremark

4.8%

13.2%

2.1%

59.9%

28.2%
Express Scripts

4.7%

14%

63.7%

24.1%
Medco

2.0%

12.3%

59.7%

38.0%
Prime Therapeutics

2.0%

8.9%

56.7%
Walgreens

4.8%

(0.07%)

61.2%

35.9%
    • They break out their best in class as having a 3.4% trend and say that clients who used proactive trend management were at 2.1% on average.
    • Best in class generic dispensing rate was 65.6% (employers) and 66.7% (health plans).
    • Mail order rate as reported in press release for close of 2007. (Not sure how to compare this to the 12.8% reported in their TrendsRx report.)
    • Overall trend was 5.5% when specialty drugs are included.
    • Had to find the generic fill rate in their 4th quarter financial press release. Either I missed it in the trend report or it was strangely missing.
    • Mail order rate was derived from the same 4th quarter release which showed 40.8M mail Rxs and 507M adjusted Rxs. Multiplying 40.8 by 3 to adjust from 90-days to 30-days and dividing that by 507 gave me the 24.1%.
    • Deriving the mail order rate from the 2007 full year press release gave me 94.8M mail order Rxs which I multiplied by 3 to get to adjusted Rxs and then divided by 748.3M to get 38.0%.
  • Prime Therapeutics trend report (Drug Trend Insights)
    • Their trend was 2.9% if specialty drugs are included. Trend ranged from (1.3%) to 7.5% across their blues clients/owners.
    • Overall trend was 5.66%. The 4.8% excludes specialty trend.
    • GDR was 69.6% if you include Medicare.
    • The 35.9% mail order rate includes their Advantage90 offering for 90-days at retail.
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Trackbacks/Pingbacks

  1. Breaking Down The 2008 PBM Customer Satisfaction Report « Patient Centric Healthcare - January 6, 2009

    […] 6.7% of respondents perceived that their benefit costs were increasing more than others and ranked their PBMs lower. (perhaps a validation that trend management matters…hence the “battle” to show the lowest year-over-year trend to the street in the individual trend reports) […]
  2. November Adler’s Drug Store Counter « Patient Centric Healthcare - November 20, 2008

    […] highlights the drug trend and generic fill rate numbers from the big PBMs (as I have done before). What it made me think about is that with Medco and CVS Caremark having lower generic fill rates, […]

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