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Obamacare plans' drug spending rose faster than other plans in 2016: Express Scripts

Obamacare plans' drug spending rose faster than other plans in 2016: Express Scripts
From Reuters - February 28, 2017

Spending on prescription drugs for health plans created under the Affordable Care Act increased last year at a rate more than three times that of other commercial plans and most government-run plans managed by Express Scripts Holding Co.

Express Scripts, the largest manager of prescription drug plans for U.S. employers, on Tuesday said year-over-year spending per person for individual insurance plans sold on the Obamacare exchanges where it manages the pharmacy benefit rose 14 percent in 2016, driven by higher drug prices and utilization.

Express Scripts said per-capita spending for other commercial plans it manages, mostly for employers, rose just 3.8 percent last year, despite an 11 percent increase in list prices for brand-name drugs.

Drug spending for plans the company manages under Medicare, the federal government health plan for seniors and disabled, increased 4.1 percent last year while the rise for Medicaid, the government plan for the poor, was 5.5 percent.

Prescription medications for chronic, costly conditions drove drug benefit usage with high-cost specialty medications - including drugs for HIV and inflammatory conditions - accounting for nearly half of total drug spending for exchange plans, the company said.

President Donald Trump and congressional Republicans have vowed to repeal and replace the Affordable Care Act, former President Barack Obama's signature piece of domestic policy known as Obamacare, but have not yet released details. Last year was the third full year of operation for the exchanges.

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