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The report shows that despite continued growth in the use of cholesteroldrugs, spending fell 8.5 percent in 2007 as usage of lower-cost genericversions of Pravachol and Zocor expanded in the marketplace, resulting inlipid-lowering medications experiencing the greatest spending decline of alldrug categories. Meanwhile, spending on diabetes drugs increased 12 percentdue to shifts toward higher-cost treatments, brand-name drug price inflation,and moderate growth in the number of patients receiving treatment.
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For a decade, cholesterol drugs were the largest driver of drug trend -- ameasure of spending growth for pharmacy benefit plans. These medicationsstill account for a sizable 10.8 percent of all prescription costs withutilization rising 5.9 percent last year as new clinical guidelines expandedthe population that can benefit from these treatments.
"Generic drugs have been a tremendous asset in controlling runaway healthcare costs," Medco Chairman and CEO David B. Snow Jr. said. "Genericcholesterol medications have helped contain our drug trend to a new all-timelow of 2.0 percent. Patients and our clients are reaping the benefits ofgenerics as we enable them to hold down costs and make prescription drugs oneof the few areas where spending trails overall health care inflation."
Diabetes patients move away from older treatments
While utilization of diabetes medications only increased a moderate 2.3percent during 2007, the cost of diabetes treatments rose sharply as patientsshifted to newer drugs. These recently introduced medications have advantagesover older drugs since they are faster-acting and can help patients bettermaintain consistent blood sugar levels to prevent complications from thedisease. A sharp drop in Avandia use due to safety concerns, withdrawal of aninhalable form of insulin, and declining unit costs for many generic versionsof diabetes drugs were not enough to offset the trend toward higher-costtreatments.
"The diabetes epidemic and the introduction of new products are reshapingprescription spending patterns," said Medco Chief Medical Officer Dr. RobertS. Epstein. "The number of people diagnosed with diabetes is increasing byabout a million patients per year -- meaning more people need complex drugtherapies to control their blood sugar. While medications are critical forcontrolling the disease, many of these cases could have been prevented ordelayed with lifestyle changes, such as diet or exercise."
Two- or three-drug combinations are frequently being used to reduce thecomplications associated with diabetes, which affects about 21 millionAmericans. However, only 7 percent of patients with the disorder achievetarget goals for blood glucose, cholesterol and blood pressure.
Reflecting the need for advanced pharmacy care, the Medco TherapeuticResource Centers(R) (TRCs) with more than 1,100 specialist pharmacists, weredeveloped to help patients with diabetes and other chronic and complexconditions. Specialist pharmacists help address prescription safety,medication compliance, and side effects, and engage patients and physiciansabout other elements of care. Specialist pharmacists help patients withdiabetes manage their complex drug regimens and supply needs, as well as themonitoring of the disease itself. The Medco Diabetes Resource Center was afinalist in URAC's Best Practices
