Post on 13-Jan-2016
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Can the Specialty Beast Be Tamed?
Steven B. Miller, MDExpress Scripts
2008 Express Scripts, Inc. All Rights Reserved.
2
Specialty Growth Continues to Outpace Traditional Drug Market
Source: Express Scripts analysis of IMS data.
21%
2008 Express Scripts, Inc. All Rights Reserved.
3
Specialty Growth Continues to Outpace Traditional Drug Market
Source: Express Scripts analysis of IMS data.
21%
27%
2008 Express Scripts, Inc. All Rights Reserved.
4
Specialty Growth Continues to Outpace Traditional Drug Market
Source: Express Scripts analysis of IMS data.
21%
27%
2008 Express Scripts, Inc. All Rights Reserved.
5
Agenda
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6
What Are Specialty Medications?
2008 Express Scripts, Inc. All Rights Reserved.
77
Overall Specialty Trend: 14%
PMPY
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“Specialty”: Now the #1 Therapy Class
PMPY
2008 Express Scripts, Inc. All Rights Reserved.
99
Utilization Drove Trend More Than Last Year
PMPY
2008 Express Scripts, Inc. All Rights Reserved.
1010
Key Specialty Therapy Classes2006:2007
PM
PY
+ 17%+ 17%
+ 1%+ 1%
- 10%- 10%
+ 20%+ 20%
+ 16%+ 16%
+ 18%+ 18%
PMPY
+ 6%+ 6%
2008 Express Scripts, Inc. All Rights Reserved.
1111
Key Specialty Therapy Classes2006:2007
PM
PY
PMPY
+ 17%+ 17%
+ 1%+ 1%
- 10%- 10%
+ 20%+ 20%
+ 16%+ 16%
+ 18%+ 18%
+ 6%+ 6%
2008 Express Scripts, Inc. All Rights Reserved.
1212
Expanded and Earlier UseInflammatory Conditions
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Expanded and Earlier UseInflammatory Conditions
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Price Drove TrendMultiple Sclerosis
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Price Drove TrendMultiple Sclerosis
2008 Express Scripts, Inc. All Rights Reserved.
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Price Drove TrendMultiple Sclerosis
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Price, Place and ProductCancer
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Price, Place and ProductCancer
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1919
Price, Place and ProductCancer
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2020
Safety Changed the Landscape
Blood Cell Deficiency
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2121
Safety Changed the Landscape
Blood Cell Deficiency
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2222
Prevalence and Price Overwhelmed Mix
Growth Hormone
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2323
Prevalence and Price Overwhelmed Mix
Growth Hormone
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Growth Hormone Use Is Rapidly
Moving Into Older Patients
Users above age 20
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2525
Medical Shifted to PharmacyAnticoagulants
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Medical Shifted to PharmacyAnticoagulants
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Where are the Patients Going?
Hepatitis C
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Where are the Patients Going?
Hepatitis C
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Hepatitis C Prevention Is Working
US has 3.2 Million Chronically Infected and 10,000 Annual Deaths
29
http://www.cdc.gov/ncidod/diseases/hepatitis/resource/PDFs/disease_burden.pdf accessed March 24, 2008
2008 Express Scripts, Inc. All Rights Reserved.
Hepatitis C Prevention Is Working
US has 3.2 Million Chronically Infected and 10,000 Annual Deaths
30
http://www.cdc.gov/ncidod/diseases/hepatitis/resource/PDFs/disease_burden.pdf accessed March 24, 2008
2008 Express Scripts, Inc. All Rights Reserved.
31
Specialty Growth Continues to Outpace Traditional Drug Market
Source: Express Scripts analysis of IMS data.
21%
27%
2008 Express Scripts, Inc. All Rights Reserved.
32
Follow-on Biologic Savings Opportunity
ESI studied four classes of specialty drugs
2008 Express Scripts, Inc. All Rights Reserved.
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Follow-on Biologic Savings Opportunity
ESI studied four classes of specialty drugs
2008 Express Scripts, Inc. All Rights Reserved.
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In the first ten years: $71 Billion Savings
$ B
illio
ns
Inflation and prevalence drive trend in this modelInflation and prevalence drive trend in this model
2008 Express Scripts, Inc. All Rights Reserved.
Every Study Says “Billions”
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Key Issues
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2007 Was An Active Legislative Year for Follow-On
Biologics
High-level excerpts of selected issues; not a complete description of legislative proposals.
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2008 Biogenerics Legislation
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Conclusions