Prescription drug cost drivers Although prescription drug spending has historically been a small proportion of national healthcare costs compared to hospital and physician services, it has grown rapidly in recent years. According to CMS, prescription drug spending increased 7.8% to $378.0 billion in 2021, up 3.7% from the previous year. A recent study found that “In 2022, overall pharmaceutical expenditures in the US grew 9.4% compared to 2021, for a total of $633.5 billion. Utilization (a 5.9% increase), price (a 1.7% increase) and new drugs (a 1.8% increase) drove this increase.” These results illustrate increasing prescription drug spending, especially with new, specialty and cancer drugs. According to the same study, employers will have to watch for a predicted rise of 6% to 8%. A multitude of factors led to this steady rise in prescription drug pricing, including the following. An influx of specialty drugs Specialty medications account for a smaller portion of U.S. prescriptions...

A 2021 CDC study found that 8.2% of Americans aged 18 to 64 skipped, delayed or reduced the amount of their prescription medications because of cost concerns. The National Health Interview Survey revealed that to reduce expenses, 9.2 million adults were not taking medication as prescribed. According to the report, about 60% of adults age 18 and older took at least one prescription medication, with 36% taking three or more. Out-of-pocket costs on retail drugs rose 4.8% to $63 billion. Since high costs limit many Americans’ ability to take their medications as prescribed, these patients may require additional treatment. 6 prescription drug cost key takeaways While this study was conducted in 2021, key takeaways are still applicable today due to rising prescription drug costs. Consider the following findings: Women (9.1%) were likelier than men (7%) not to take medication as prescribed. The percentage of adults not taking medication as prescribed due to cost varied by race and origin: n...

Rapidly increasing healthcare costs will likely continue to impact employers for the foreseeable future. As a result, many employers are considering strategies to manage these costs, including rising prescription drug costs. The introduction of biosimilar drugs as an alternative to biologics may bring value to healthcare by offering cost savings and increasing employee access to necessary medications. While biosimilars can potentially combat rising prescription drug costs, employers will need to learn more about them before considering how their health plans can accommodate these newer drugs. This article explores biosimilar drugs and ways employers can promote or manage their use. What are biosimilars? The European Medicines Agency defines a biosimilar as “a biological medicine highly similar to another already approved biological medicine.” It is produced from living organisms — humans, animals or microorganisms, meaning they aren’t created from synthesized chemicals. They are also ...