Prescription drug costs soar 1998-99

From Drug Benefit Trends

Trend of the Month
Drugs Take Bigger Slice of Total Health Care Expenditures
[Drug Benefit Trends 13(8):11, 2001. 2001 Cliggott Publishing Co., Division of SCP/Cliggott Communications, Inc.]

  Prescription drug charges have increased at a faster rate than all other medical services. Between 1998 and 1999, charges for prescription drugs increased from 22.9% to 25.3% of the total charges per member per year, according to the Express Scripts 2000 Drug Trend Report (see cover). The rate of increase in drug spending, however, slowed slightly in 2000 to 16.2%, in part because no new blockbuster drugs were introduced. In 1999, the drug spending increase was 17.4%, primarily because of the introduction of the anti-inflammatory drugs Celebrex and Vioxx. Factors contributing to the overall prescription drug cost increase were higher prices for existing products, use of more expensive products, stronger dosages, and more units per prescription. New drugs introduced in 2000 accounted for only 0.3% of the overall 1999 to 2000 trend. However, drugs introduced since 1992 accounted for approximately 47 cents of each dollar spent on prescription drugs in 2000. Overall, more prescriptions were filled for females than males in 2000. However, little difference was evident in the percentage of prescriptions attributed to each sex in the 2 youngest and 2 oldest age groups. Although females filled 60.8% of prescriptions during 2000, they made up only 50% of the members in the Express Scripts database. More prescriptions are filled by females in all age groups except 0 to 9 years. In general, women were impacted more than men by the cost increases as the predominant users of thyroid drugs, estrogens, and antidepressants. The per-prescription cost of branded estrogen products, although relatively low in real terms, went up 14% last year. It was the biggest percentage increase among branded products in the top 25 therapy classes. Similarly, thyroid drugs accounted for the largest change among generics at 22.7% and, for all brands, generic or branded, at 13.2%. Men were the predominant users of prescription drugs for cardiovascular conditions, such as antihyperlipidemics and antihypertensives. These drug classes, plus calcium channel blockers, b-blockers, and diuretics -- which also treat heart conditions -- accounted for 18% of all prescription drug spending in 2000, as well as 18% of last year's overall spending increase. Per-prescription costs for drugs typically prescribed for children younger than 10 years increased 17.6%, more than for any other age category. For the most common drugs prescribed for children younger than 10 years, the average wholesale price per prescription increased from $28.25 to $33.23.

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