Medicaid Drug Spending Growth Hit Double Digits in 2021, Magellan Rx Reports

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.

gross-cost-net-cost-trend

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.

top-10-drug-classes-by-net-spend

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.

medicaid-forecasting

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.

© 2024 MMIT
Jinghong Chen

Jinghong Chen Reporter

Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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