Study shows rising cost of specialty drugs in country, Nebraska

The Blue Cross Blue Shield Association (BCBSA) and HealthCore, Inc. study shows that per member specialty pharmacy spending increased 26 percent from 2013 to 2014.

The study found:
  • There was an $87 annual per member increase in specialty pharmacy spending from 2013 to 2014.
  • The increasing costs of specialty drug treatments were the main driver of the growth in spending. Treatment costs include the price and selection of drugs. Increased utilization had a smaller effect on the growth in spending.
  • In 2014, annual specialty drug spending was 17 percent higher per member who had individual insurance compared to those insured by an employer.

Here in Nebraska, in 2013 and 2014 there was an increase of 29 percent in specialty drug spending. In 2014 and 2015 the increase was 44 percent.  

The top categories of drugs by cost were diabetes, autoimmune, multiple sclerosis and oral cancer medications, increasing 15 to 30 percent in 2015.  Meanwhile there are fewer new blockbuster generic drugs available to offset the increases. 

What can be done to lower specialty drug increases?
  • We encourage customers to use generic prescription medicines, mail order delivery and home infusion, when available, and help people follow medication plans as prescribed by their doctors.
  • Hold down health care costs through prescription drug tiers or lists, which set different out-of-pocket costs for different types of prescription medicines.
  • Greater competition and choice to bring costs down for everyone, including speeding up the approval of generic drugs.
  • Transparency regarding the pricing of prescription medicines with information about price and a drug’s effectiveness made widely available to the public.



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