Specialty Drug Spending Continues to Rise, Driven by Higher Utilization

Per-member per-year (PMPY) specialty drug spending rose 13.6% from 2018 to 2019, according to Pharmaceutical Strategies Group’s annual report, which analyzed 45 million pharmacy claims and 54 million medical claims. Contributing to the growth was a 10.3% increase in utilization and a 3.3% rise in costs per claim. Specialty drug spending under the pharmacy benefit saw the largest increase, driven by 19.6% higher utilization of such therapies. In terms of overall cost, inflammatory disorders ranked No. 1 among all drug categories, followed by oncology and multiple sclerosis.

© 2023 MMIT
Jinghong Chen

Jinghong Chen Reporter

Jinghong produces infographics and data stories on health insurance and specialty pharmacy for AIS Health. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting. Before joining AIS in 2018, she worked at WBEZ, Al Jazeera English and The New York Times Chinese.

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