Cancer conditioncategories accounted for $378 million (48 percent) of the totalincrease in spending, with the largest increases for specifiedspecialty drugs. (Photo: Shutterstock)

The use of very expensive specialty drugs is increasing—and sois the cost to employers, according to a research study by Prime Therapeutics LLC.

Prime's study analyzed the 2016-2018 pharmacy claims data ofmore 17 million commercially insured members, to identify thetrends of "drug super spender" members, defined as those withgreater than $250,000 in total drug cost per year. While still asmall population—0.0275 percent of all members in 2018—the group'spercentage of total drug spend is increasing—from 6.3 percent in2016 to 8.6 percent in 2018, or roughly $2.1 billion in drugspend.

Related: 10 drugs topping employers' pharmaspend

During those two years, the number of drug super spenders jumped63 percent, to 4,869 members—and their costs also jumped, 60percent, to $2.1 billion. In that same time frame, the number ofdrug super spenders with drug costs more than $750,000 increased 38percent, and drug costs for members more than $750,000 increased to$417 million in 2018 from $297 million in 2016.

"With continued growth in treatments for rare diseases,including one-time treatments that may carry million-dollar price tags, it's very likelythat health care cost will become even more skewed, with a smallerand smaller fraction of insured members accounting for a larger andlarger portion of the total health care cost," says Prime's seniorvice president, chief medical officer Jonathan Gavras.

"We must work to ensure drug and gene therapies are pricedappropriately to the value they provide, obtained and billed viathe cost-effective channel with the highest quality patientmanagement, and value-based contracts are in place to recoup costsif the drug or gene therapy does not maintain effectiveness,"Gavras says.

Of the $795 million increase from 2016 to 2018 in drug superspenders' total drug expense:

• Cancer condition categories accounted for $378 million (48percent) of the total increase, with the largest increases forspecified specialty drugs to treat breast, multiple myeloma, lung,kidney, colorectal, non-Hodgkin's lymphoma and melanomacancers.
• Inherited single gene disorders accounted for $243 million (31percent) of the total increase with the largest increases seen forhemophilia A and B, cystic fibrosis, spinal muscular atrophy,congenital hypophosphatasia, hereditary angioedema, cystinosis andDuchenne muscular dystrophy drug therapies.
• The other categories accounting for nearly all the remainderincrease in drug super spender expense from 2016 to 2018 were: thetreatment conditions for eculizumab (Soliris) includinghemolytic-uremic syndrome, paroxysmal nocturnal hemoglobinuria, andmyasthenia gravis; pulmonary hypertension; multiple sclerosis; andanti-inflammatory biologics.

Read more: 

• Curbing specialty drug spending: Where tostart?
• Copay accumulator programs leave consumers on thehook for high drug costs
• Majority of Americans support current efforts tobring down drug prices