A new issue brief by America's Health Insurance Plans explores the recent trends in the specialty drug market and recommends policy solutions to promote high-value, high-quality care.
Despite accounting for just 1% of prescriptions written in 2014, specialty drugs represented nearly one-third of the total prescription drug spending. With specialty drugs representing an increasing share of the US prescription drug spend, addressing the cost trend is becoming critical to ensure affordability for businesses and consumers.
A new specialty drugs issue brief by America’s Health Insurance Plans (AHIP) explored the recent trends in the market and recommended policy solutions to promote high-value, high-quality care.
The unsustainable growth of spending on specialty drugs is the result of many factors, but mostly legal and regulatory treatment of specialty therapies is to be blamed, according to the issue brief.
AHIP explains that one of the biggest issues is the lengthy exclusivity period—12 years for brand-name biologic drugs—granted to specialty drugs.
“Granting lengthy exclusivity periods to specialty drugs removes the economic benefits of price competition, resulting in higher prices relative to what they would be in a perfectly competitive market,” according to the brief.
In addition, there is evidence of manufacturers gaming the system to prolong the exclusivity period even longer through a number of schemes including: “evergreening,” where manufacturers make minor changes to a drug’s chemical composition or delivery mechanism to extend the patent; and “product hopping,” when the company withdraws a drug from the market and introduces a new version with minor changes.
The AHIP brief recommended a number of policy options that would promote high-quality, cost-effective drug coverage, including:
“These recommendations represent actionable steps that could be implemented to ensure the efficient and effective use of these high-cost treatments while—at the same time—promoting continued medical advances and innovations that offer promise and benefit patients and consumers,” the brief concluded.
Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
Listen
Data Back Neoadjuvant Combo vs Chemo Alone for Early-Stage NSCLC
April 24th 2024For patients with early-stage non–small cell lung cancer (NSCLC), combining neoadjuvant immune checkpoint inhibitors and platinum-based chemotherapy improves 2-year outcomes over chemotherapy alone, suggest findings of an extensive literature review and meta-analysis.
Read More
Overcoming Employment Barriers for Lasting Social Impact: Freedom House 2.0 and Pathways to Work
April 16th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our second episode, in which we learn all about Freedom House 2.0 and the Pathways to Work program.
Listen
Patient Navigation in Oncology at Heart of Priority Health White House Visit
April 24th 2024On March 27, Priority Health's president and CEO, Praveen Thadani participated in a discussion on how to expand and optimize patient navigation services in oncology care, as part of the Cancer Moonshot initiative.
Read More