CVS Health Corp.’s 2019 drug trend report shows a 1.4% overall trend, the lowest in five years, and said 41% of its commercial clients saw negative trend. Specialty drugs accounted for almost half of all spending and remained the fastest growing spending category in the pharmacy benefit. Autoimmune treatments, including some of the highest volume medications — Humira, Enbrel, Rituxan and Remicade — comprised a third of specialty pharmacy spending. CVS’s Advanced Control Specialty Formulary (ACSF) helped its clients reach -9.4% price growth in the category. As 20 biosimilars are expected to come to the specialty marketplace by 2023, payers may see significant savings, according to CVS.