UNC-CH Study Finds Specialty Drug Spending Triples Since 2003

Jul 8, 2016

Spending on high-price specialty drugs has risen dramatically in the past thirteen years, according to new research from UNC-Chapel Hill.

Stacie Dusetzina is an assistant professor of pharmacy and public health at the Eshelman School of Pharmacy. She analyzed data from a national prescription database to chart trends for drugs costing $600 or more per month. She found that despite accounting for just two percent of all drugs prescribed, health care spending for specialty drugs rose from 11 percent to 43 percent since 2003.

"We can see that they make up a fraction, a very tiny proportion of the use of drugs, but they are really dominating spending," she said.

Dusetzina said this is a growing problem for patients who pay a percentage of their prescription costs, rather than a flat co-pay.

"If you imagine that your drugs that you're taking are $10,000 a month, for example, you could be paying a large percentage of that, or a very high dollar amount," she said.

She noted that in some cases, consumers are paying hundreds of dollars each month for brand name drugs when generics are available.

But for the most part, specialty drug spending is driven up by the cost of newer drugs used to treat conditions for which few options exist. Prescriptions to treat rheumatoid arthritis, hepatitis C, diabetes and multiple sclerosis are some of the most expensive medications, costing thousands of dollars each month. Those prices, she said, can make it difficult for patients to access the medication they need.

"We want to make sure that if products are really providing good values for patients, that they can afford them, so they’re really able to access all of the drugs that are prescribed and recommended by their doctors," said Doucetzina.

She suggested drug spending could be reduced by relying more on generic medications, and by establishing a model where insurance companies link payment to patient health outcomes, paying only when a high-priced drug proves effective.