In 2021, the net cost per prescription drug claim in 25 Medicaid fee-for-service (FFS) programs went up 11.0%, or $5.81, according to Magellan Rx Management’s latest annual Medicaid Pharmacy Trend Report. It is the first time that drug spending growth reached double digits since the inception of Magellan’s report in 2016. Net spending on specialty drugs continued to see double-digit growth at 13.0%, compared with 10.9% in 2020, while net trend on traditional drugs rose 5.8%, up 4.1 percentage points from 2020. For the second year in a row, specialty drugs accounted for more than half of total drug spending in Medicaid FFS, while only representing 1.3% of total pharmacy utilization.
Cytokine and CAM antagonists were the therapeutic class with the largest impact on net cost per claim in 2021, adding $0.93 in net trend. When drugs were ranked by their share of total net spending in 2021, medications for HIV/AIDS topped the list, accounting for 10% of total net Medicaid spending. The report also identified six specialty drugs and five traditional drugs as the main drivers of total net spending. Combined, these 11 drugs accounted for 21.9% of total net spending, according to data from Magellan Rx’s Medicaid FFS pharmacy programs in 24 states and the District of Columbia.
Looking forward, the report predicted that both gross and net cost trends for drugs covered by Medicaid FFS programs will drop over the next few years. Spending on the most expensive classes of drugs, such as HIV/AIDS treatments, is likely to keep trending upward, while stimulants and related agents and inhaled glucocorticoids were anticipated to trend down “as generic utilization increases and downward pricing pressure continue to lower the total net cost” for the medications in these classes, according to the report.
SOURCE: “Magellan Rx Management Medicaid Pharmacy Trend Report, 2022 Seventh Edition,” Magellan Rx Management.
This infographic was reprinted from AIS Health’s biweekly publication RADAR on Drug Benefits.