WOONSOCKET, R.I. — CVS Caremark has released its annual Drug Trend Report, which found that specialty medications accounted for 52% of drug spend in 2020. Specialty spending has recently increased due to several market conditions. David Steinberg,  director of Pharmacy Insights at Scripta Insights, breaks down the history of this trend and what it really means.

The FDA defines a biosimilar as “a biological product that is highly similar to and has no clinically meaningful differences from an existing FDA-approved reference product.”

“Biosimilars have been granted FDA approval at an increasingly higher rate,” said Steinberg. “To illustrate, in 2015 and 2016, a total of four biosimilars were approved, while in 2019 ten biosimilars hit the market. With additional medications available and increased competition, generally prices would go down, but that is not the case when it comes to specialty medications.”

“Manufacturers are competing for formulary space with PBMs and providing greater rebates for that tier and formulary placement. Higher rebates translate to higher list prices and higher costs to plan sponsors,” said Steinberg. “Another factor that has contributed to higher specialty use is simply more options for patients and doctors to choose from. In the past, treatments for conditions such as psoriasis were limited to topicals, now, physicians are opting for more systemic specialty treatments without regard to the cost, both to the patient and the plan.”