In April 2015, The Segal Group consultancy said it was raising its pharmacy benefit cost trends forecast for 2015 to range from 13 to 15 percent. Segal’s initial pharmacy benefits cost trend forecast for 2015, issue in late 2014, had been 8.6 percent.

“This increase is driven by substantial expansion in the use of higher cost specialty medications being dispensed to patients as well as higher manufacturer price increases being passed along to consumers on often-prescribed brand and generic drugs,” commented Dr. Ritu Malhotra, PharmD, vice president and national pharmacy benefits practice leader at the firm. “We are also seeing excessive prices as well as misuse in prescribing compound medications. Another factor is that there are limited cost offsets coming from new generic launces in the near term.”

Added Edward A. Kaplan, senior vice president and national health practice leader for The Segal Group, “Pharmacy benefit costs per covered employee are approaching levels equal to what group health benefits plans spend on inpatient hospital claim expenses. We are looking at prescription drugs as potentially the biggest driver of cost increases for providing group medical coverage in the next few years. Employers and plan sponsors will need to examine new cost containment strategies requiring more financial and clinical data about treatment choices and coverage options in order to get drug cost trends to more sustainable levels.”

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