2021 drug trend report
Perspective: Better care, lower cost| Capability: Pharmacy | By: CarelonRx
Medical and pharmacy overall drug spend has been on the rise. Through its integrated, total health approach, CarelonRx (formerly IngenioRx) was able to mitigate those effects and improve health outcomes for its customers.
In 2021, increases in medical and pharmacy overall drug spend were primarily driven by utilization, inflation, and the arrival of new drugs on the market
Through the enhancement of existing programs and development of new mitigation strategies, CarelonRx was able to provide personalized pharmacy care and help keep spend down. Those efforts led to a low single-digit trend, savings on both the specialty and non-specialty sides, reduced out-of-pocket expenses, and greater value for its customers.
2021 drug trend by the numbers
3.6%
Overall trend
Medical + Rx
-1.7%
Non-specialty
7.1%
Specialty
Medical + Rx
Mitigating trend effects with new programs and strategies
Last year, CarelonRx launched new clinical programs that resulted in an estimated $750 million in incremental savings.
Trend mitigation strategies included, but were not limited to:
- Evidence-based formularies and clinical edits
- High-touch member outreach
- Cost-management strategies
- Utilization and channel management
- Pharmacists partnering with providers
What about the specialty space?
On the specialty side, combined utilization and channel management strategies delivered savings of over $300 million — $453 per utilizing member per year. Clients that used our full suite of clinical-management strategies spent an average of $2,639 less in drug costs per member per year compared to those that did not.
In particular, focus was placed on oncology solutions, knowing that cancer care has a big impact on healthcare. CarelonRx’s oncology initiatives generated approximately $41 million in incremental savings. For a member with cancer, that meant nearly $1,100 in additional annual savings.
Take a closer look at 2021 trend drivers and how CarelonRx helped its customers manage costs while improving health outcomes.
40%
of clients had a negative overall trend
40%
of clients had a negative speciality trend
(medical + pharmacy)
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