Specialty Drug Costs on the Rise

Even as the cost of prescription drugs has plummeted for many Americans, a small slice of the population is being asked to shoulder more and more of the cost of expensive treatments for diseases like cancer and hepatitis C,according to a report to be released on Tuesday by a major drug research firm.

The findings echo the conclusions of two other reports released last week by major pharmacy benefit managers, which predicted that spending on so-called specialty drugs would continue to rise.

The report, by the IMS Institute for Healthcare Informatics, also found that consumers’ use of health care — visits to the doctor, hospital admissions and prescription drug use — rose in 2013 for the first time in three years, mainly because of the improving economy, it said.

“Following several years of decline, 2013 was striking for the increased use by patients of all parts of the U.S. health care system,” Murray Aitken, executive director of the IMS Institute, said in a statement. He noted that the spike came before the Affordable Care Act, which has helped provide health insurance to millions of new customers, fully went into effect.

But even as consumers became more confident about spending money on health care last year, the report found that a divide is developing between those with medical conditions that can be treated with cheap generic drugs, and those with rare and often more serious diseases that can come with breathtaking price tags.

More than half of prescriptions cost patients, on average, less than $5 in out-of-pocket costs in 2013, and 86 percent of them were filled with generic medicines. Nearly a quarter of all prescriptions — 23 percent — required no out-of-pocket cost at all, an increase that the report’s authors attributed mainly to a requirement in the new health care law that contraceptive drugs be covered free.

On the other hand, those who need the costlier drugs paid disproportionately more. Only 2.3 percent of prescriptions accounted for 30 percent of all out-of-pocket costs, the report found.

Drug companies have increasingly turned to treatments for smaller and more complex diseases as sales of dozens of blockbuster drugs have collapsed in recent years in the face of competition by cheaper generic versions.

In 2013, drug companies debuted 36 new drugs, including 10 notable cancer treatments, the most in more than a decade, the report found. Other significant new drugs on the market included treatments for hepatitis C, multiple sclerosis and diabetes. Pharmaceutical companies began selling 17 drugs last year to treat so-called orphan diseases — those that affect fewer than 200,000 people nationwide.

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