Transcript Slide Deck - Minnesota Health Action Group

What Senior Management
Needs to Know about
Specialty Drugs
How specialty drugs affect our bottom line
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Total health benefit costs pm/py: XX
Total pharmacy cost pm/py: XX
Specialty pharmacy cost pm/py: XX
Specialty pharmacy trend over the past X years: XX
Projected specialty pharmacy costs for the next 3 years:
XX
 Spend in top therapeutic classes: XX
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Taking action at [ORGANIZATION NAME]:
Right drug, right price, right place, right support, right data
[ED. NOTE: Customize this slide with what you are doing to
address the concerns on slide 2]
 ACTION ITEM 1
 ACTION ITEM 2
 ACTION ITEM 3
 ACTION ITEM 4
 Collaborating with Minnesota
employers to drive marketplace
change
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[ED. NOTE: THE FOLLOWING SLIDES ARE OPTIONAL. PLEASE
SEE EXECUTIVE TALKING POINTS FOR TIPS ON HOW TO
INCORPORATE THEM INTO A MEETING.]
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The supply chain is complex with many
“middlemen”
Adapted with permission from Pembroke 2013-14 Economic Report on Retail, Mail and
Specialty Pharmacies; Drug Channels Institute
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The market doesn’t work for drugs:
Annual cost of MS therapies increased 500% in 10 years
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BETASERON
AVONEX
$61,848
$58,524
(2016)
(2016)
$11,532
$8,723
(1993)
(1996)
COPAXONE
REBIF
$84,132
$61,800
(2016)
(2016)
$8,292
$15,262
(1997)
(2002)
SOURCE: The cost of multiple sclerosis drugs in the US and the pharmaceutical industry: Too big to fail?
Neurology, 84 May 26, 2015, pp.1-8
© Minnesota Health Action Group; confidential – do not copy or distribute without permission
Current cost trends are unsustainable
Specialty drug approvals continue to surpass their traditional counterparts
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© Minnesota Health Action Group; confidential – do not copy or distribute without permission
Specialty drug spending to double in 4 years
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© Minnesota Health Action Group; confidential – do not copy or distribute without permission
40 MS patients increase costs by $52 for every
plan member at one large employer
Multiple Sclerosis and Plan Cost: 2013
(MS therapy prices have increased 500% in a single decade)
Courtesy of Dr. Stephen Schondelmeyer
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© Minnesota Health Action Group; confidential – do not copy or distribute without permission
Bundled and unknown costs
MN Drug Spending by Therapeutic Category 2013 –
Bundled and Unknown is Largest
$ in Millions
Endocrine/Metabolic
CentralNervous System
Cardiovascular
Analgesics & Anesthetics
Respiratory
Anti-Neoplastic
Gastrointestinal
Anti-Infective
Miscellaneous
Topical
Psych & Neurology
Hematological
Stimulants, Obesity & Anorexia
Neuromuscular
Genitourinary
Biologicals
Nutritional
Bundled & Unknown
$600
$400
$200
$800
$1,000
$791 million
$545 million
$515 million
$510 million
$445 million
$425 million
Rx Benefit (Drug $)
Medical Benefit (Drug $)
$349 million
$343 million
$340 million
$333 million
$311 million
$261 million
$249 million
$230 million
$95 million
$76 million
2013 Total Spending on Drugs = $7.51 billion
2013 Pharmacy Benefit Drug Spend = $4.74 billion
2013 Medical Benefit Drug Spend = $2.77 billion
$59 million
$1,627 million
SOURCE: Analysis by the PRIME Institute, University of Minnesota, using the Minnesota
All Payer Claims Database (MN APCD) data from 2009 to 2013.
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The 5 rights at a high level
Right
Right
DRUG
PRICE
Right
10
Right
PATIENT
SUPPORT
PLACE
Right
DATA
© Minnesota Health Action Group; confidential – do not copy or distribute without permission