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12:00 AM
May 26, 2014
 |  BioCentury  |  Strategy

Measured exclusion

Why PBM Catamaran not including specialty drugs on new excluded drugs list

At a time when some PBMs are cracking down on mounting specialty drug costs through tools like excluded drugs lists, Catamaran Corp. is taking a more measured approach. The excluded drugs list the PBM plans to release next month will not include specialty drugs.

Instead, Catamaran aims to use more traditional tools to keep growth in check, while employing its medication therapy management program to optimize use of drugs it does pay for.

In its annual drug trends report issued in March, Catamaran forecast a 2.8-7.7% increase in overall drug spending each year for the next three years.

The PBM spent $14.6 billion on drugs in 2013, up 2.4% from $14.3 billion in 2012.

However, spending on the specialty drug class jumped 14.3% over 2012. The top three categories among the specialty class are autoimmune, oncology and multiple sclerosis (MS) drugs.

Catamaran expects specialty drug spending to increase 16-23% annually through 2016, compared to nearly flat outlays for traditional drugs: -1.6-0.6%.

The report is consistent with forecasts from fellow PBM Express Scripts Holding Co., which reported specialty drug spending increased 14.1% in 2013 and forecast specialty drug growth of 16.8-18.2% through 2016.

CVS Caremark LLC reported that its specialty spend increased by 15.6% in 2013 and forecast an...

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