Specialty drugs that treat complex conditions, such as cancer, can cost between $500,000 and $2 million. These drugs now make up more than 50 percent of total drug spending, according to Prime.
For the study, researchers analyzed data on more than 17 million commercially-insured patients with at least one month of eligibility in each year between 2016 and 2018. In 2018, 4,869 people were classified as “super spenders,” meaning their drug costs totaled more than $250,000 per year.
The number of people defined as super spenders increased by 63 percent between 2016 and 2018 and resulted in $800 million in additional drug costs. The number of patients with more than $750,000 per year in drug costs increased by 38 percent. Total drug prices for this group increased from $297 million in 2016 to $417 million in 2018. Overall, super spenders accounted for $2.1 billion of health plan drug costs in 2018, or 8.6 percent of total drug spend.
“With continued growth in treatments for rare diseases, including one-time treatments that may carry million-dollar price tags, it’s very likely that healthcare cost will become even more skewed, with a smaller and smaller fraction of insured members accounting for a larger and larger portion of the total healthcare cost,” Jonathan Gavras, MD, senior vice president and CMO at Prime, said in a news release.