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Follow the Numbers: A Focus on Anti-Inflammatory Medications

In addition to having a major impact on patient health outcomes, medications can have significant cost implications for all stakeholders; insurers and employers need to work with their pharmacy benefit managers to ensure that the right patients are getting the right medications at the right time.

Published Online: May 10,2017
Jan Berger, MD, MJ
The annual spring ritual of pharmacy benefit managers (PBMs) releasing their drug trend reports has begun, and one area of great interest has always been in answering the question, “What are my top drugs?”
Over the last few years, we have seen a greater number of specialty medications find their way into payers’ top 10 lists, and drugs for inflammatory or autoimmune diseases, such as Embrel and Humira, have increasingly become some of the most prevalent. Data from Prime Therapeutics show that use of this class of medications increased by over 10% from 2015 to 2016.1
Further, the recently released Express Scripts 2016 Trend Report stated that, for their clients, the trend for this class rose by 26.4%.2
Today, there are only 15 medications that can be classified as anti-inflammatory drugs. Drugs for anti-inflammatory diseases will find new competitors over the next few years, yet 10 years ago, there was a paucity of medications to treat these significant illnesses. As more medications become available, there will be more choices for the patient and payers to choose from.
However, it is not only new brand medications coming to market worth considering; an increasing number of biosimilars will also become available. It is unknown at this time how biosimilars affect this class of medications and its associated trend, but the 3 most common drugs—Remicade, Humira, and Enbrel—will soon have biosimilar versions available. 
When looking at drug trends, most organizations focus on the individual components of drug utilization, cost, and mix. Another study from Prime Therapeutics found that there was a 38% increase in use between 2012 and 2015 for anti-inflammatory medications.3
One of the reasons commonly thought to increase the use of anti-inflammatory medications was the change in healthcare provider' decision to begin using these medications earlier in a patient’s treatment. Subsequently, this created a situation where higher-cost medications were being utilized without knowing if lower-cost medications would be effective.