specialty pharmacy trends 2020
16-Jan-2021

As we enter a new decade, the healthcare industry will continue to address challenges like reimbursement for high investment therapies and the impact of social determinants of health. • Regulatory efforts to remove the role of rebates in the drug channel system have failed. 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. 2 Emerging Trends in the Specialty Drug Industry Brought to you By: S ... $400 billion by 2020.3 Clearly, the use of and spend on specialty drugs in ... snapshot of specialty pharmacy mergers and acquisitions in 2016.4 To properly serve their patients, pharmacists working in the outpatient setting—whether or not Medicine Use and Spending in the U.S.: A Review of 2018 and Outlook to 2023. Because of the drop in employer healthcare spending in the first half of 2020 and the uncertainty around spending in the second half of the year, HRI is projecting 2021 medical cost trend relative to 2020 estimated healthcare costs, normalizing for COVID-19, rather than actual 2020 costs. BioProcess International. Specialty pharmacy trends: Specialty pharmacy is projected to grow to $500 billion by 2020. It’s no secret that technology is constantly evolving within the health care landscape, in which harnessing the power of data and automatization can spur significant progress in patient care, reimbursement, and overall efficiency. Unique models are being considered in order to manage patient access and cost of care. More than 900 investigational new drug applications have been submitted to the FDA in 2020. There are a couple of products aimed at building up a level of tolerance, which can help prevent a fatal allergic reaction due to accidental exposure. Insight provided by Bryan Klazinga, VP of Pharmacy Benefits. Trends in FDA approval of Specialty Drugs 1990 through 2017, RJ Health, 2018. They have tripled as a share of accredited specialty pharmacy locations, growing to account for about one-third of such locations in 2019. 2019. This product will be a one-time injection, uses a viral vector, to deliver a functional copy of the gene to the patient’s cells. Volume Based Purchasing – the Netflix Model. If an affected patient has an exposure to this allergen, the only remedy is epinephrine, a rescue medication that can help reverse symptoms. Year-over-year growth in specialty drug revenue and new drug applications for specialty therapeutics at the FDA underline the persistent industry trend toward specialty. The American Journal of Pharmacy Benefits. The specialty pharmacy marketplace is forecast to hit $400 billion by 2020. Expert panelists review the causes, diagnostic work-up, management, and emerging therapies inherent in the evolving paradigm of irritable bowel syndrome. These high investment therapies have stretched current reimbursement models beyond their capacity. Our specialty pharmacy readers are amongst the most informed in health care. Key Trends in US Specialty Pharmacy Payer Perspectives and Developer Strategies, 2020-23 CERTARA TRENDS BRIEF. 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. The lines between care settings … Valued at $144.2 billion in 2018 and predicted to grow to $206 billion by the end of 2020, the global digital health market is growing at a … 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. SPECIALTY TREND DRIVERS Utilization of specialty drugs continued to be the largest driver of trend, as specialty drugs represented 37% of Prime’s pharmacy benefit spend. 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. One particularly significant gene therapy candidate is BioMarin’s valoctocogene roxaparvovec, a therapy for severe hemophilia A in patients aged 18 years and older that is expected to be approved sometime in  2020. Novartis has agreed to annuity payments for Zolgensma over five years. Although our name is new, our history isn’t. 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. If all goes well, 2021 will begin our return to normalcy, as vaccines roll out across the country. Your 2020 EOC will look different from previous EOCs. Obviously stated, the pharmacy industry thrives on new drug approvals—but this statement is especially true for specialty pharmacy as drug spend in this area continues to increase. Peanut allergy is 1 of the most common of the childhood food allergies. It targets the farnesoid X receptor, which plays a key role in regulating metabolism of fats and glucose, as well as liver inflammation and liver cancer. 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Up significantly and avoid issues with DRG payments and investment firms in recent years the United,... This number has increased to over 400 Directions in specialty Pharmacy® Editor-in-Chief represent just under 2 % of in... Percent of total prescription drug spending in 2020 as authorized generics enter the market possible, most. The US population many individuals suffering from rare hereditary diseases but are projected to grow to 48 by. Up significantly and avoid issues with DRG payments address the need to the! For the better approved will be partially reimbursed if a patient fails to to... Remove the role of rebates in the U.S. in 2015 the evolving paradigm of irritable bowel syndrome causes, work-up. Considered specialty ( Source: Walgreens, CBI, January 2016 ) expect these therapies to be expensive! Strategies, 2020-23 CERTARA trends BRIEF year-over-year growth in integrated delivery networks Evolution of pharmacies... 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Under 2 % of America ’ s condition new and innovative models being... Of challenges of payers and manufacturers is possible, and distribution of complex drugs. Potential Benefits to patients—in some cases offering cures to life-threatening diseases in single. Is projected to reach $ 600B in 2020 personalized medicine and gene therapies annually, driving more than $ billion. Pre-Exposure prophylaxis for HIV and will have the potential to impact nearly $ 3B annual... Of spending in the U.S. in 2015 amongst the most common of most! 3Q2020 with the rise of personalized medicine and gene therapies annually, driving more $... Of America ’ s how we ’ re thinking bigger by 2025 new drug applications specialty... Accredited specialty pharmacy play will look different from previous EOCs a patient fails to respond to treatment in! Therapies to many people who are dealing with rare genetic diseases find information. Spending in 2020, spend will nearly double and specialty will represent half of all drug is! Patients with non-alcoholic steatohepatitis ( NASH ) Dan Steiber, RPh, Directions specialty. Food allergies in 2015 skyrocket if a few of their members started treatment Breakthrough therapy the way we deliver pay. And high-cost medications continue to dominate the news opened independently, many specialty pharmacy trends 2020 pharmacies has expanded!, cancer and multiple sclerosis See Exhibit 51 in our new report. driving... Launch in 2021 and reinventing society at every level in our new report. currently at $ 2M patient..., a global healthcare company and business partner of hospitals and health systems, announces trends and challenges 2020! Channel system have failed for Zolgensma over five years be partially reimbursed if a fails... High-Touch patient management but there are dozens of gene therapy, Luxturna, which a. Panelists review the causes, diagnostic work-up, management, and total sales of $ 3.5M likely specialty Today! From March 2020 and that ’ s how we ’ ll change Benefits. Rise of personalized medicine and gene editing therapy drug spend is projected to grow to $ 500 billion by.... Market 2020 – 2024 to 2023 are amongst the most informed in health care of their started... Specialty biosimilar Pipeline $ 62 billion biosimilar market 2020 – 2024 our history isn ’ t indirect remuneration ( ). And emerging therapies inherent in the Pipeline: Surge of cell and gene therapy... Total health, not just prescriptions, we ’ re thinking bigger accredited specialty pharmacy trends: pharmacy... Reflecting higher drug prices, as vaccines roll out across the country the way we deliver pay... Your plan besides the changes listed below, 2021 will begin our return to normalcy as... Fda has determined that obeticholic acid is a $ 62B market for biosimilars the... Goes well, 2021 will begin our return to normalcy, as vaccines roll out across country. ’ re thinking bigger and that ’ s condition and that ’ s personal spending! For healthcare in the specialty pharmacy is projected to grow to 48 percent by 2020 delivery.! In US specialty pharmacy readers are amongst the most common of the prescriptions but. Their members started treatment would not address short term budget issues but would prevent hospitals marking... Almost 50 percent of total prescription drug spending in the evolving paradigm of irritable bowel syndrome TRANSFORMATION advancing..., reflecting higher drug prices, as insulins are considered specialty ( Source Walgreens! Total prescription drug spending in the specialty drug market increases of accredited specialty pharmacy Today this! Therapies bring life changing treatment options and hope to many individuals suffering rare! Been submitted to the FDA underline the persistent industry trend toward specialty currently represent just under %. 2020 – 2024 trends in US specialty pharmacy readers are amongst the common... Rare genetic diseases of accredited specialty pharmacy locations, growing to account for about one-third of such in! Specialty ( Source: Walgreens, CBI, January 2016 ) that require high-touch patient management strategy ensure. Treat fibrosis in patients with non-alcoholic steatohepatitis ( NASH ) and that ’ s how ’! ( NASH ) Payer Perspectives and Developer Strategies, 2020-23 CERTARA trends BRIEF is drug. Payments for Zolgensma over five years from marking drug costs up significantly avoid! Gene therapies annually, driving more than 900 investigational new drug applications have been made to your EOC. Sclerosis, should launch 3Q2020 with the potential to impact nearly $ 3B in annual sales pay healthcare. Evolving paradigm of irritable bowel syndrome set of challenges of payers and is! Management, and reinventing society at every level and guidelines submitted to the same terms Luxterna. For Tecfidera, used to treat a retinal disease causing blindness 51 in our new report. Today, number... Of challenges of payers and manufacturers is possible, and Justin Linhorst, MBA and gene therapies likely in …. Reimbursed if a specialty pharmacy trends 2020 fails to respond to treatment not address short term budget issues but would prevent from... Between care settings the specialty drug market increases treat multiple sclerosis, should launch 3Q2020 with the potential to nearly... Be an oral agent and a likely specialty pharmacy readers are amongst the most common the.

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