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Magellan Rx Management's Annual Medical Pharmacy Trend Report ReleasedMagellan (News - Alert) Rx Management, the pharmacy benefit management (PBM) division of Magellan Health, Inc. (NASDAQ: MGLN) today released its eighth annual Medical Pharmacy Trend Report, which is the industry's leading resource for benchmarking key trends, analytics and approaches to managing high-cost specialty drugs paid under the medical benefit. This year's report shows that in 2016, commercial health plans' per-member per-month (PMPM) medical benefit pharmacy trend underwent the largest jump in five years due to rapidly evolving market dynamics and increases in drug pricing. "The commercial PMPM trend was at an all-time high-21 percent-a 62 percent difference over the 13 percent average annual trend of the last five years," according to Casandra Stockman, Pharm.D., vice president of medical pharmacy strategy. "Cost differences by site of service, rising drug prices and costly new therapies are the largest contributing factors driving the rapid growth in medical pharmacy spend." Noteworthy new analyses this year found that only 10 percent of commercial patients and 21 percent of Medicare patients are driving nearly all medical pharmacy spend, 94 percent and 96 percent, respectively, attributed to specialty versus traditional drug spend. "New entrants, programmed-cell death (PD)-1 inhibitors Opdivo (nivolumab) and Keytruda (pembrolizumab) played a significant role in the 2016 medical benefit drug trend," according to Stockman. "Most notably, Opdivo entered the top five drugs by spend for Medicare Advantage, making it the first time since the inception of our report that a new drug entered the top five Medicare drugs listing." Other key highlights from the Medical Pharmacy Trend Report:
Key strategies for the effective management of medical benefit drug spend outlined in the report include:
"With the growing impact of the specialty drug market, it is crucial that health plans have a strong infrastructure and robust management framework for medical benefit drugs to control escalating spend and improve quality outcomes," said Stockman. The report is based on survey responses from medical, pharmacy and network directors from 46 commercial and Medicare Advantage payers representing more than 128 million covered lives. Medical benefit drug utilization and trend data were collected through secondary analyses of commercial and Medicare Advantage health plan medical paid claims data across 925 HCPCS codes and several outpatient sites of service, including the physician office, home and hospital outpatient facility. To learn more about the latest medical pharmacy trends and key management strategies, join our webinar on March 15, 2018, at 1 p.m. Eastern. Register here. Magellan Rx Management is a full-service, next generation, pharmacy benefit manager (PBM) with a value-driven approach that moves past the traditional volume-focused thinking to deliver meaningful solutions. Our services expand beyond traditional core services to help our customers and members solve complex pharmacy challenges by connecting them to the people, technology and information they need to make smarter healthcare decisions. As pioneers in managing specialty spend both on the prescription and medical benefit, we are effectively-positioned to continue delivering thought-leading solutions in this complex and rapidly growing area of healthcare to help people live healthier lives. Magellan Rx Management is a division of Magellan Health, Inc. About Magellan Health, Inc.: Magellan Health, Inc. is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com. (MGLN-GEN)
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