Medco 2009 Drug Trend Report

Here are my highlights from Medco Health’s 2009 Drug Trend Report:

• Overall trend was 3.3%.  (1.3% excluding specialty drugs.)
• Specialty trend was 15.8%.
• Their generic fill rate was 64.1%.
• Interestingly, they broke out trend to show that clients with over 40% mail use had a trend of -0.7% while those with less than 40% had a trend of 5.8%.
• I do like the generic distribution chart below although it is for 2008 Q4 while their 64.1% number is for the average of 2008.

• They point out that utilization growth was negative 1.1% last year which was the first time in a decade.  What I was surprised at is that they didn’t “blame” the economy for this.  Most surveys I have seen say or imply that people are taking less medications because of the increasing cost burden while their overall wealth is decreasing.
• Medicare costs increased 6.8% for their PDP (prescription drug plans).

• I think it’s interesting in helping companies focus their management efforts when they project that “in the next 3 years more than 85% of drug trend will be driven by drugs in six categories: cardiovascular, endocrine/
  diabetes, central nervous system, musculoskeletal/rheumatology, respiratory, and oncology”.
• In a brief section about the unwired state of healthcare, they share some scary statistics:
  • A review involving the medical records of 41 million Medicare patients identified $8.8 billion in error-associated costs and 238,837 preventable deaths. Moreover, a large subset of these errors are medication errors.
  • An estimated 1.5 million preventable serious medication errors occur each year, with $217 billion (2006 dollars) in associated costs.
• Since people are always asking for quantifiable value around adherence, I liked the chart below which showed the survival rates over years based on adherence vs. non-adherence.

• They introduce a new metric – Generic Opportunity Score (GOS).  It takes into account both chemical and therapeutic opportunities for generics to be used.
• They also provide some details on a brand-to-generic $0 copay waiver program which had a 14% success rate.  That’s pretty good from what I have seen.
• Here is a breakout of the specialty pharmacy categories:

• Now, where they do credit the economy is with improving generic fill rate, mail order utilization, and client’s use of trend management programs.
• They show trend by age group with the lower age groups growing faster.  They also showed a nice graph of utilization by state.

• Below is their chart on where trend growth in the future is projected to occur (which should tell you where to focus preventative action).