First-of-Its-Kind, Multidisciplinary Roundtable on Specialty Pharmacy Explores Access, Adherence and Cost for Fastest-Growing Segment of Prescription Drug Market
- At Nearly 25 Percent of Overall Drug Spend, Specialty Pharmaceuticals Represent An Explosive Prescription Medications Market; Expected to Reach 40 Percent by 2030
A first-of-its-kind multidisciplinary roundtable discussion about specialty pharmacy and its impact on the health care system convened today in New York City. The discussion was moderated by Susan Dentzer, Editor-in-Chief of Health Affairs, one of the nation’s leading health care journalists, and featured experts from clinical practice, disease and patient advocacy, bioethics, the pharmaceutical industry and pharmacy benefits management.
Roundtable panelists included Nancy Berlinger, Ph.D., Deputy Director and Research Scholar, The Hastings Center; Jacqueline Kosecoff, Ph.D., CEO, Prescription Solutions; J. Ross Maclean, M.D., MBA, Vice President, Health Services, Bristol-Myers Squibb; Lee N. Newcomer M.D., Senior Vice President of Oncology, Women’s Health and Genetics, UnitedHealthcare; P.J. Weiner, Senior Manager, Advocacy Programs, National Multiple Sclerosis (MS) Society-NY; and Kenneth Bandler, MS patient advocate.
During the Roundtable discussion, participants discussed how to ensure that patients understand and use specialty pharmaceuticals correctly and achieve better health outcomes; which best practices can be leveraged for cost savings in the health care system; and how the future of these drugs will take shape.
Consensus emerged from the diverse group of panelists around the benefits of creating a national patient registry to: collect data on the number of people with chronic diseases such as MS; determine the efficacy and value of treatments; and inform continued research, including off-label use.
In the view of many experts, specialty pharmacy has reached a tipping point and is changing the health care landscape. Specialty pharmaceuticals are forecasted to be the top selling drugs by revenue by 2014. “At a time when the drug development pipeline is filling up with specialty drugs, it becomes more important and challenging than ever to ensure that affordable, clinically sound treatment options are available to people -- but at a cost that is sustainable for the nation,” said Dentzer.
Specialty pharmaceuticals, also known as biologics, are a relatively new class of drugs that have both value and important treatment implications for people with a wide range of disease states including multiple sclerosis, hemophilia, hepatitis, rheumatoid arthritis, certain types of cancer and many others. Specialty pharmacy classifications include nearly 400 different drugs across 25 therapeutic categories. Biologics also represent nearly 25 percent of overall drug spend and are an explosive prescription medications market in terms of growth and cost. It is estimated that specialty pharmacy spend will climb to more than 40 percent by 20301.
Approximately 57 million working-age Americans live with diabetes, asthma, rheumatoid arthritis, cancer, HIV and other serious diseases2. Many of these individuals are able to continue working and be productive members of their communities due, in large part, to the introduction of highly effective specialty pharmaceuticals.
“It’s time to ask ourselves some very specific questions,” said Dr. Kosecoff. “How do we help patients stay on their treatment regimens? How do we achieve both clinical value and affordability? Are we doing enough to reward drug manufacturers for investing in the development of curative drugs? These are just some of the crucial questions that will require us to work together to address diverse perspectives and constituencies including consumers, policymakers, purchasers and manufacturers.”
Other topics explored during the Roundtable included:
- What is government’s responsibility in ensuring access to these drugs?
- Should longer exclusivity be offered for drugs that are curative or significantly extend longevity or quality of life?
- Should all patients on specialty drugs be required to be in a registry? Should education be required so that patients understand the costs and benefits of a treatment?
“Because specialty drugs often have challenging side effects, many patients have trouble sticking with their prescribed medication regimen. Low adherence to prescribed therapies not only affects a person’s health outcomes, but also drives up the overall cost of treatment due to disease complications,” said Dr. Newcomer. “There’s evidence that when patients receive support and education on proper medication use, they stay on their therapy longer and have improved outcomes at reduced costs. This is a win-win for patients, physicians and payers.”
The roundtable was sponsored by Prescription Solutions, a leading pharmacy benefits management organization and a UnitedHealth Group (NYSE: UNH) company.
About Prescription Solutions
Prescription Solutions is an innovative pharmacy benefit management company managing the prescription drug benefit of commercial, Medicare and other governmental health plans, as well as those of employers and unions. A UnitedHealth Group company, Prescription Solutions serves patients through a national network of 64,000 community pharmacies and state-of-the-art mail service pharmacies in Carlsbad, Calif., and Overland Park, Kan., both of which have earned the prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS®) accreditation by the National Association of Boards of Pharmacy® (NABP®). The company was recently named by WilsonRx® as the No. 1 National Top-Tier PBM and No. 1 National Mail Order Pharmacy for customer satisfaction two years in a row. Prescription Solutions also won two Silver Awards for URAC’s Best Practices for Consumer Empowerment and Protection Awards – Geriatric RxMonitor program (2008) and the Drug Interaction Alert Program (2009). Additional information can be found at www.prescriptionsolutions.com.
About UnitedHealth Group
UnitedHealth Group (www.unitedhealthgroup.com) is a diversified health and well-being company dedicated to helping people live healthier lives and making health care work better. With headquarters in Minnetonka, Minn., UnitedHealth Group offers a broad spectrum of health benefit programs through UnitedHealthcare, Ovations and AmeriChoice, and health services through Ingenix, OptumHealth and Prescription Solutions. Through its family of businesses, UnitedHealth Group serves 75 million people worldwide.
1Specialty Pharmacy: Stakeholders, Strategies and Markets Third Edition, 2008 AIS
2Center for Studying Health System Change, 2003 Community Tracking Study (CTS) Household Survey.