The presidential candidates may talk about combating high drug prices, but Express Scripts' Dr. Steve Miller said it takes more than tough talk to make it work. He should know. He helped Express Scripts clients save more than $1 billion on hepatitis C drugs in 2015.
"We can reward companies that are willing to give us lower prices," said Miller, chief medical officer at the nation's largest pharmacy benefit manger, which manages drug benefits for 85 million Americans.
Express Scripts excluded Gilead Sciences' $1,000-a-pill hepatitis drug Sovaldi from its approved drug list last year. By going with a rival brand exclusively, Express Scripts was able to secure a steep discount, cutting the cost of therapy in half.
"We now are a year into it, we've treated over 50,000 patients with hepatitis C," said Miller, the company's chief medical officer. "We've treated more people than ever and had more people cured than ever, at a tremendous savings."
Those measures helped clients hold down overall drug spending growth to 5.2 percent last year, about half the growth rate in 2014 when Sovaldi was the only new hep C drug on the market.
Much of the growth in spending was due to double-digit price increases in high-cost specialty drugs, according to new data in Express Scripts 20th annual drug-trend report. Spending on specialty medications to treat inflammatory conditions such as rheumatoid arthritis topped the list for the first time, as prices spiked nearly 20 percent.
Two of the top rheumatoid brands face competition from non-branded biosimilars in 2017, said Dr. Glen Stettin, chief innovation officer at Express Scripts.
"They're doing what we typically see brand manufacturers do when they face the potential of generic competition, and that's raise the price ahead of the new drugs coming to market," he said.