Pharmaceutical Strategies Group (“PSG”), an EPIC company, released the Artemetrx State of Specialty Spend and Trend report. This annual report provides a comprehensive analysis based on real world data of utilization of specialty medications across both pharmacy and medical benefits.

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This year’s report revealed per member per year specialty drug cost increased from $1,333 in 2023 to $1,641 in 2024. However, specialty drug trend decreased to 9.6% in 2024 on a gross cost basis, a decline from 14.4% in 2023. Notably, cost per claim was meaningfully less of a contributor to trend this year versus recent years. “The data reveals a compelling story regarding what is happening with specialty drugs. Overall costs continue to increase for healthcare payers, but what is driving that cost is changing,” stated Morgan Lee, PhD, Senior Director of Research & Strategy at PSG. “Adoption of Humira biosimilars helped pull specialty trend down this year, which is evident throughout the report,” Lee added.

While Humira continued its multi-year reign as the top specialty drug in terms of overall spend, this popular drug experienced negative utilization and cost per claim trends driven by the adoption of biosimilars. “In 2024, we saw the benefit to healthcare payers of Humira biosimilars as PBMs shifted strategies to take advantage of competition in the market,” observed Renee Rayburg, RPh, Vice President of Clinical Strategy at PSG. “We expect to see faster adoption of Stelara biosimilars, which entered the market early this year. However, we’re also seeing a push to move patients from these drugs to other brand drugs that do not have biosimilar competition.”

The Artemetrx State of Specialty Spend and Trend Report reflects PSG’s commitment to providing data-driven insights regarding the management of and opportunities to optimize specialty medications. The complimentary report can be downloaded here. Additional findings covered in the report include:

• The percentage of members utilizing a specialty drug increased (4.7%), while average specialty claims per utilizer was steady (5.9)
• The shift of specialty drug spending to the pharmacy benefit continued
• The top three categories for specialty drug spend remained unchanged: Inflammatory Disorder, Oncology, Multiple Sclerosis

PSG will host a webinar on August 13th, at 1:00 ET to discuss how this report can shape a roadmap for proactive specialty spend control. Registration is available online.

About Pharmaceutical Strategies Group (PSG)

Pharmaceutical Strategies Group, an EPIC company, relentlessly advocates for clients as they navigate complex and ever-changing drug cost management challenges. PSG is an independent consultant, empowering healthcare payers to optimize their pharmacy program. As a strategic partner, PSG helps clients by providing industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year. www.psgconsults.com

About Artemetrx®

Artemetrx is a proprietary SaaS platform developed by Pharmaceutical Strategies Group, an EPIC company. As a revolutionary technology solution integrating pharmacy and medical claims data for specialty drug cost management, Artemetrx provides market-leading specialty drug insights to payers. It delivers unparalleled intelligence and line-of-sight into serious challenges perpetuating out-of-control drug costs and compromised patient outcomes. PSG’s innovative drug management solutions, including Artemetrx, deliver actionable insights with exceptional financial and clinical value. PSG functions as a strategic partner through industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year. https://www.psgconsults.com/solutions/data-analytics

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