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?
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77
Overall Specialty Trend: 14%
PMPY
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8
“Specialty”: Now the #1 Therapy Class
PMPY
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99
Utilization Drove Trend More Than Last Year
PMPY
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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%
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1212
Expanded and Earlier UseInflammatory Conditions
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1313
Expanded and Earlier UseInflammatory Conditions
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1414
Price Drove TrendMultiple Sclerosis
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1515
Price Drove TrendMultiple Sclerosis
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1616
Price Drove TrendMultiple Sclerosis
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1717
Price, Place and ProductCancer
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1818
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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24
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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2626
Medical Shifted to PharmacyAnticoagulants
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2727
Where are the Patients Going?
Hepatitis C
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2828
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
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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
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33
Follow-on Biologic Savings Opportunity
ESI studied four classes of specialty drugs
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34
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
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Every Study Says “Billions”
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36
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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39
Conclusions
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