CMS Report Cites Managed Care Pharmacy Practices in Lowering Future Drug Spending Rates

 Alexandria, Va., July 31, 2015 — A new report from the Centers for Medicare and Medicaid Services (CMS) finds that prescription drug spending increased 12.6 percent in 2014, the highest growth rate since 2002. But CMS also projects that this rate will decelerate by roughly half over the next 10 years, citing managed care pharmacy practices among the reasons for the drop.

According to the report, released July 28, spending growth has been driven by factors such as increased pharmaceutical use among people who were newly insured under the Affordable Care Act, the introduction of new high-priced specialty drugs to treat hepatitis C, and the aging baby boomer population.

Going forward, however, CMS projects that prescription drug spending will decelerate to an average of 6.3 percent annual growth from 2015 through 2024. This will be due in part to changes in benefit management designs that encourage better drug adherence for people with chronic health conditions, CMS says. Growth also is expected to slow as payers negotiate lower costs with manufacturers on expensive specialty treatments such as those for hepatitis C, it adds.

The Academy of Managed Care Pharmacy (AMCP) CEO Edith A. Rosato, RPh, IOM, issued the following statement on the report:

“AMCP is gratified to see that CMS recognizes the value of managed care pharmacy practices in moderating the growth of pharmaceutical spending over the next decade. Managed care pharmacy tools and strategies, including those around ensuring appropriate utilization and adherence, have been shown to improve health outcomes while controlling overall health care costs. As expensive new therapies continue to enter the marketplace, managed care pharmacists will work to control health care costs by ensuring the right products are being used by the right patients, and that appropriate follow-up is performed to confirm the patient is compliant and demonstrating success.”

To access the CMS report, visit here.