My firm, Health Strategy Associates, has conducted a survey of prescription drug management each year for the last five. I’m well into the survey portion of the Sixth Annual Survey, and here are some preliminary findings.
1. Drug cost inflation appears to show signs of rebounding after five years of decreases in the rate of increase. The data is by no means complete, but most of the respondents to date reported cost inflation was higher in 2008 than the previous year.
2. More respondents are tracking their first fill capture rate this year than last. There appears to be a significant focus on this metric, based at least in part on the sense that the earlier the PBM can get involved in a claim, the more likely it will be able to minimize over-prescribing and inappropriate dispensing.
3. Respondents are more aware of the actual strengths and weaknesses of specific PBMs than they were in the past; the buyers with strong knowledge of and experience in this niche are pretty savvy.
4. The primary cost driver remains utilization – too many of the wrong type of drugs dispensed by too many physicians, especially for pain.
5. Clinical management programs are increasingly important to payers (see 5. above), and they are getting smarter about these programs, what works and what doesn’t, and why. Marketing pitches aren’t cutting it any more; these folks want to see programs in action, study the reports, and understand the logic.
The report will be out next month. If you’d like to download copies of the previous reports, click here.
Aug
25
