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Last week, Express Scripts released its new 2015 Drug Trend Report...For the first time, the Express Scripts data account for rebates—a meaningful and welcome improvement in reporting methodology. After accounting for rebates, the 2015 report reveals that drug spending growth is comparable to growth in other parts of the healthcare system. For some payers, utilization (script growth) was a bigger driver of spending than drug prices...So much for the myth of exploding drug costs! Our politicians may not believe it, but Martin Shkreli et al. are the exception in the pharmaceutical industry. Below, I review the four key highlights about traditional and specialty drug spending, trend patterns for different payers, and a red flag from upcoming biosimilar launches.

FOUR TAKEAWAYS

1. Commercial payers were better able to control costs.
2. More people are getting access, which is “good” spending.
3. Specialty growth continues.
4. Hunker down for the biosimilar formulary wars.

...Anthem Inc said it had sued pharmacy benefit manager Express Scripts Holding Co to recover damages from drug pricing it believes was too high...latest development in a months-long dispute over Anthem's contract with Express Scripts...The lawsuit also seeks to recover damages from operational issues and for a declaration of Anthem's right to terminate its contract with Express Scripts…Anthem, which has been seeking $3 billion in annual cost savings through a repricing provision in its 10-year contract with Express Scripts, said it had not yet decided whether to end the contract...The latest news has taken a very unhealthy turn and we see it unlikely that Anthem renews its contract with Express Scripts past 2019, and is likely to leave sooner to the extent it can manage the transition for consumers smoothly...Express Scripts...said in a statement that it believed the lawsuit to be without merit. The company has consistently acted in good faith and in accordance with the terms of its agreement with Anthem…

A British vote to leave the European Union would threaten some prescription medicines with regulatory limbo, posing a legal headache for drugmakers, according to lawyers and industry officials...The highly regulated pharmaceutical sector has more at stake than most from a so-called Brexit, prompting top manufacturers GlaxoSmithKline and AstraZeneca, both of which oppose exit, to draw up detailed contingency plans...Currently, under EU rules, drugmakers launching a medicine get a single marketing approval that allows them to tap the entire European market of 500 million potential patients...In the event of a British exit, UK firms could no longer apply for or hold EU marketing authorizations, unless or until the UK negotiated to be part of the EEA. Licences would have to be transferred to businesses inside remaining member states..."The potential complexities around such issues as marketing authorization simply highlight the problems that could be faced by companies and patients alike in the event of exiting the EU,"...GlaxoSmithKline said leaving the EU would create uncertainty, add complexity and making some short-term disruption likely...

ASHP has released the ASHP Specialty Pharmacy Resource Guide, a new publication that outlines ways for hospitals and health systems to address the challenges and opportunities presented by specialty pharmacy, the fastest growing segment of the pharmaceutical industry... It is projected that by 2020, specialty pharmaceuticals will represent half of all drug expenditures, driving pharmacy directors to seek out strategies to address the impact of the products on pharmacy services. The resource guide discusses the financial, legal, administrative, and patient care aspects of four specialty pharmacy business models and helps users determine which model best matches their needs.

Centers for Disease Control and Prevention...issued a new guideline for prescribing opioids...for chronic pain that is not related to cancer or end-of-life care. The document’s goal is to curb...a doctor-driven prescription overdose epidemic...Of the guideline’s 12 recommendations, the top one states that non-drug or at least non-opioid drug approaches should be tried before opioids...the Office of the Assistant Secretary for Health at the Department of Health and Human Services released a national pain strategy that emphasized the need to treat chronic pain with a variety of well-tested approaches, not just medication...Non-drug approaches to relieving chronic pain, such as exercise, weight loss and talk therapy, have the advantage of not needing warning labels, and research suggests that they can be as effective as NSAIDs. But they take more time and effort than swallowing a pill.

According to PDS (PDS Life Sciences), SEND Express is a "turnkey solution for the generation of Standard for Exchange of Nonclinical Data datasets."...We aggregate and harmonize data from multiple organizations, information systems and file formats...to produce one set of harmonized SEND files, including define.xml and define.pdf, as required by the FDA...The platform's launch parallels the FDA's deadline for standardized electronic data submissions, which will require all datasets from studies supporting new drug applications, biologics license applications, and abbreviated new drug applications to be submitted in SEND format by Dec. 17...Having an industrywide, harmonized model allows for efficient analysis by regulatory authorities...The common formats assist in enabling the exchange of nonclinical data within companies and consortiums...this consistency of data makes it easier for vendors to develop tools that can use this data...

The National Association of Chain Drug Stores...announced the expansion of its get-out-the-vote initiative for 2016, with new video ads to encourage pharmacy personnel to volunteer and vote for the candidates of their choice...The new ads are part of the larger NACDS RxIMPACT Votes get-out-the-vote effort, one aspect of NACDS’ suite of grassroots advocacy resources under the NACDS RxIMPACT name. The ads will bear the "hashtag" #PharmacyVoter that will be used in social media to foster a community-wide focus on voter engagement. NACDS also launched PharmacyVoter.org – a website targeted to the pharmacy community to showcase the effort... The first 30-second ad — called "Effective" — debuted...during the launch of NACDS RxIMPACT Day on Capitol Hill, when nearly 400 pharmacy advocates will meet with 90% of the U.S. Congress to discuss key patient care issues.

New safety warnings also added to all prescription opioid medications to inform prescribers and patients of additional risks related to opioid use...Food and Drug Administration...announced required class-wide safety labeling changes for immediate-release opioid pain medications...the FDA is requiring a new boxed warning about the serious risks of misuse, abuse, addiction, overdose and death...actions are among a number of steps the agency recently outlined in a plan to reassess its approach to opioid medications. The plan is focused on policies aimed at reversing the epidemic, while still providing patients in pain access to effective relief.

The Poison Prevention Week Council aims to educate consumers about the prevention of unintentional poisonings and accidental exposures around the home. This year’s National Poison Prevention Week focuses on preventing accidental medicine ingestions by young children. The Up and Away and Out of Sight campaign reminds consumers that storing medicines safely is an important part of preventing poisonings in the home...This year National Poison Prevention Week is March 20 through March 26...Additional information and poison prevention educational resources are available on the Poison Prevention website...NABP’s AWARxE Prescription Drug Safety Program website has advice on properly storing medications to prevent accidental ingestion...in the Secure Storage section. The AWARxE website also has a Drug Disposal Locator Tool that provides locations of permanent drug disposal sites in the US. Safely disposing of unwanted medications can help prevent exposing young children to accidental ingestion.

Medicine Shoppe Canada and its parent company, McKesson Canada, on Friday announced a partnership with Quality Foods, a Canadian grocery chain, to drive better patient experience in retail pharmacy...This partnership will see the opening of a new, state-of-the-art pharmacy within a leading grocery store – designed with evolving patient centric care models in mind. Long-time community pharmacist, Larry Johannessen...will operate the new location within the Port Alberni Quality Foods..."As pharmacists, patient and customer care is at the heart of what we do, each and every day", Johannessen said. "I’m excited to partner with Quality Foods to welcome patients into our new facility as we expand access to patient care."