1 With the rise of personalized medicine and gene editing therapy drug spend is projected to reach $600B in 2020. Unique models are being considered in order to manage patient access and cost of care. Specialty pharmacy has been a top trend for the past several years as utilization and drug spend have dramatically increased across healthcare. Expert panelists review the causes, diagnostic work-up, management, and emerging therapies inherent in the evolving paradigm of irritable bowel syndrome. Specialty Pharmacy Trends for 2020 and Beyond. When we look back ten years from now, my hope is that we can say “remember when we treated cancer with toxic chemo therapy and genetic disorders went relatively untreated?” That will certainly make the hard work we have to do well worth it. Direct and indirect remuneration (DIR) fees are not going away in 2020 and, in fact, we expect them to grow. Stanton D. In the pipeline: Surge of cell and gene therapies likely in 2020. ... 2020 Trends in Pharmacy Care: Technology. Can Formulary Management Bring It Down to Earth?, Managed Care, 2019, FAQs About Rare Diseases, Genetic and Rare Diseases Information Center, U.S. Department of Health and Human Services, 2017, https://www.cigna.com/newsroom/news-releases/2019/pdf/cigna-health-services-business-pioneers-an-innovative-solution-to-affordably-bring-life-changing-therapies-to-patients.pdf, http://image.messageinsite.com/lib/fe5615707d600c747210/m/2/757027d4-dff0-4c1b-a50a-ce78326b9917.pdf, 5 Ways Talking to Strangers May Boost Your Emotional Intelligence, Driving Optimal Results Through Individual/Team Performance-Based Incentive Compensation Plans, The Future of Benefits Administration Technology for HR Professionals, Most Brokers Say They Have All the Answers, COVID-19 and Mid-Year Plan Amendments – Employer Compliance Checklist, 7 Steps to Take When a Star Employee Disengages, University of Memphis – Academic Training in HR Management, Is Western Governors University Accredited | Read the Latest World News - News World, The Three Top Challenges to Earning a Degree, Factors in Assessing Your Hiring Strategy - HRProfessionalsMagazine, Recruiting Tips During Times of Uncertainty, Gloria Sinclair Miller, SHRM-SCP, SHRM Field Services Representative, Dr. Kathy Tuberville Recipient of 2020 HR Professional Excellence Award, Profile: Emily M. Dickens, SHRM Corporate Secretary and Chief of Staff, Preview of SHRM-Atlanta SOAHR Conference March 25-27. They anticipate approval of 10 – 20 gene therapies annually, driving more than $8.6 Billion in healthcare expenditure by 2025. Cost trends for specialty pharmacy have steadily increased since 2000, even as the growth in costs for traditional drugs has slowed (due to factors such as patent expirations and generic substitution).12 Recent research suggests that per capita growth for specialty drugs is in the double-digits: The biosimilar for Truvada is expected to launch in 2021. The number of health systemâowned SPs represented 27% of the accredited SPs in 2018, compared to 16% in 2015. and the author shall not be responsible for any liability arising from or related to the use or accuracy of the information in any way. Specialty products and services were considered the most profitable among all the pharmacy trends for this year, and 2020 will see a bigger market for these medications as they become part of the top pharmacy trends for 2020. You can watch the full video below. Sales of Zolgensma totaled $361M in 2019. See below a snapshot of specialt⦠Spark agreed to the same terms for Luxterna to treat a retinal disease causing blindness. The first biosimilar was launched in the U.S. in 2015. Specialty drugs are used for the treatment of complex, chronic, or rare conditions such as cancers and hepatitis C. IQVIAâs Medicine Use and Spending Report calculated that per capita drug spending on specialty drugs increased by 55% from 2013-2016. Progress has been exceptional but these high investment therapies have also introduced new challenges for employers and the payer community.4The 1983 Orphan Drug Act was enacted to incentivize research for rare diseases which are estimated to afflict 10% of Americans. The State of Specialty Pharmacy 2020: Market Data and Trends (video) In May, I recorded a brief video webinar for an on-demand business education session at Asembia's 2020 Specialty Pharmacy Summit Virtual Experience. Between 2020 and 2027, retail drug spending under private health plans is projected to increase at an annual rate of 3% to 6%; besides the slow growth of the US biosimilar market, the report cited new costly therapies, mainly specialty drugs, as well as a drop-off in the impact of lower-cost generics. Significant advancements will bring curative therapies to many individuals suffering from rare hereditary diseases. Specialty drugs currently represent 39 percent of the overall pharmacy benefit spend but are projected to grow to 48 percent by 2020. Cancer (oral) and autoimmune treatments were the most influential drug categories in driving higher trend for all lines of business with trends in the double digits. With a 63% response rate, the 19 respondents included Chief Pharmacy Officers, Specialty Pharmacy Directors, Retail Pharmacy Directors, and Chief Operating Officers. Gene therapy is designed to correct inherited genetic defects therefore it is curative and preventative for future generations.The FDA has approved 4 gene therapies to date, including Zolgensma (Novartis), approved to treat a rare spinal defect. THE SHIFTING LANDSCAPE ACCESS TRENDS IN SPECIALTY PHARMACY 2020-23 7 US specialty drug spending saw a modest annual growth of 3%, from 44.7% in 2018 to 47.7% in 2019 per ESI.10 On the basis of non-discounted spending, specialty growth has been outpacing traditional product growth, with a 10% to 0.3% dollar volume increase, per IQVIA. It is a pre-exposure prophylaxis for HIV and will have the potential to impact nearly $3B in annual sales. High investment therapies have stretched current reimbursement models beyond their capacity. The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers vii The U.S. Pharmacy Distribution and Reimbursement System for Patient-Administered, Outpatient Brand-Name Drugs The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers discusses the three key channel flows illustrated above: Volume Based Purchasing – the Netflix Model. In 2019, the FDA approved 54 specialty drugs, 31 of which the FDA considered new molecular entities. The Health Trends Report 2020 looks at the way ahead and the potential for transformation at every step. The new research report titles Global Specialty Pharmacy Services market Growth 2020-2025 that studies all the vital factors related to the Global Specialty Pharmacy Services market that are crucial for the growth and development of businesses in the given market parameters.The report highlights the important elements related to the market such as the market size, share, company ⦠As specialty drugs have gained a stronger foothold in the United States, the creation and utilization of specialty pharmacies has also expanded. Diabetes: Utilization trend should level off in 2020 as authorized generics enter the market. Nothing on this website should be interpreted as an opinion by Pembroke Consulting, Inc.. or the author on the investment prospects of specific companies. Learn from Specialty Rx Experts: 1st Episode of AscellaHealth Educational Webinar Series âSpecialty Market Trends and the Market Place Realities for Pharmacy Benefit Managersâ PBMs: Generating Savings for Plan Sponsors and Consumers February 2020 5 Americans are without insurance.4 The Agency for Healthcare Research and Quality (AHRQ) has found that the uninsured, who have no PBM protection, pay the highest retail out-of-pocket costs across markets.5 PBMs and their clients guide how actively pharmacy benefits are managed within the context of applicable The State of Specialty Pharmacy 2020: Market Data ... Why Do CVS And Express Scripts Rely on Secretive P... Copay Maximizers Are Displacing Accumulators—But C... Walgreens and CVS Top the 28,000 Pharmacies Profit... PBMs and Drug Spending in 2019: CVS Health and Exp... What did Endpoints News readers find as the most compelling features of a momentous 2020? do not make investment recommendations, on this website or otherwise. 2020-01-31 15:32:00. Hereâs a look at eight trends that experts expect will shape the industry next year: Continued shift to value-based care. ... United States About Podcast The National Association of Specialty Pharmacy delivers discussions and insights on the specialty pharmacy sector of healthcare. Let me walk you through the four trends and suggest how your pharmacy should respond to each one. Diagnosis and Treatment of IBS. About The Author. Podcast episodes examine current trends, key conferences, and critical topics in the industry. More than 900 investigational new drug applications have been submitted to the FDA in 2020. It is estimated that 17% of Americaâs personal healthcare spending is for drug therapy. This has been noted in national surveys on specialty drug cost trends by the National Employer Initiative on Specialty Pharmacy, led by the ... Planning a Specialty Drug Strategy Through 2020 . Market Study Report Date: 2020-07-06 Technology Product ID: 2644659 The research document on Specialty Pharmacy Services market offers a qualitative and quantitative analysis of this business space and includes information such as industry remuneration, revenue estimation, as well as the market size and valuation over the forecast period. Here are the top 10, Opinion: Routine testing is essential to combat Covid-19 surges, Pfizer to supply US with 100 million more doses of vaccine, The inside story behind Pfizer and BioNTech's new vaccine brand name, Comirnaty, Medical record indexing in the EHR era: Podcast with EDCO CEO Andrew Fehlman, ShopRite plans to distribute COVID-19 vaccine, HDA issues statement on COVID-19 emergency relief package, Amgen Receives FDA Approval for Rituximab Biosimilar Riabni, American biopharmaceutical manufacturing: Fueling economic growth now and for years to come, The Pharmacy Benefit Brief | December 2020, Vaccine Development and Approval in a Time of Pandemic, Central Focus: Targeting Unmet Need in CNS, The role of specialty drugs in the pharmacy industry, Our latest data on specialty pharmacy accreditation, Commentary on PBM’s role in the specialty industry. Key Trends in US Specialty Pharmacy Payer Perspectives and Developer Strategies, 2020-23 CERTARA TRENDS BRIEF. Precision medicine targets specific genes, based on the patient’s condition. BioProcess International. Value based arrangements and risk sharing across plan sponsors, PBMs, Payers and manufacturers is being considered in order to sustain affordability, ensure access to care and continue to incentivize manufacturer research and development efforts. Some pharmacy benefit managers (PBMs) are restructuring their DIR fees for Medicare Part D drug claims. Click here if you can’t see the video below. Unique Reimbursement Models for High Investment Therapy. Puts the onus on the Payer to prove failure of efficacy. increasingly innovative strategies. 2019. Oncology: Trend could be up slightly in 2020 due to increased utilization and pricing of oral drugs, such as Ibrance ® (palbociclib). 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. Specialty drugs are expected to represent almost 50 percent of total prescription drug spending in 2020. Top therapy areas, which contributed to trend, are autoimmune/anti-inflammatory drugs, along with cancer drugs for lung and breast cancer, due to increased costs over older treatments and brand inflation. Dr. Adam J. Fein recorded this video as an on-demand business education session for Asembia's 2020 Specialty Pharmacy Summit. It would not address short term budget issues but would prevent hospitals from marking drug costs up significantly and avoid issues with DRG payments. I review: Changing DIR fee structure. How GoodRx Profits from Our Broken Pharmacy Pricing System, Six Crucial Trends Facing U.S. Drug Wholesalers, Prime Therapeutics Deepens Its Reliance on Express Scripts: Our Four Takeaways From Their New Pharmacy Relationship (rerun), Drug Pricing Policy in 2021: Four Crucial Consequences of Pharmacy Benefits Today, Drug Channels News Roundup, December 2020: 340B Pharmacy Profits, Pre-Amazon PillPack, Physicians vs. Accumulators, Maine’s Importation Fail, and Vaccine Humor. 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