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BIO Statement on Blue Cross Blue Shield Prescription Drug Spending Report

May 3, 2017

Washington, DC (May 3, 2017) – Biotechnology Innovation Organization (BIO) President and CEO Jim Greenwood issued the following statement regarding today’s prescription drug spending report from Blue Cross Blue Shield:

“Today’s report from Blue Cross Blue Shield is merely the latest tired exercise in which the insurance industry seeks to shift the blame for rising healthcare costs and its own increasing cost-shifting to patients to pharmaceutical companies by cherry-picking data that fails to tell the whole story.

“Most notably, the report fails to account for the substantial impact of manufacturer rebates in lowering net prices for prescription drugs. In 2015, these rebates and other price concessions reduced spending on prescription drugs by more than 27% (IMS Institute for Healthcare Informatics, April 2016). While BCBS claims that such an omission “is an industry and actuarial practice for commercial business” when reporting drug spending trend, that claim is belied by a recent report on commercial drug trend from Prime Therapeutics – a pharmacy benefit manager which serves 20 BCBS plans and more than 20 million members.

“That report found that Prime Therapeutics’ BCBS commercial clients saw just a 2.5 percent increase in overall drug costs for 2016, with unit-cost increases accounting for a mere 0.6 percent of that spending increase. Meanwhile, overall national healthcare spending rose 4.8 percent last year, according to the Centers for Medicare & Medicaid Services (CMS).

“Recently released data in CMS’ National Health Expenditure Projections also throws cold water on the notion that prescription drug spending is growing unsustainably. CMS revised its 10-year projection of prescription drug spending downward by $18 billion, and projects that it will grow roughly at the same rate as total U.S. health care spending over the next decade. Highlighted separately from the health expenditures data, CMS also has projected that drug pricing growth in 2017 will be a mere 1.6 percent, the lowest inflation rate for drugs in a decade.

“Rising patient out-of-pocket costs for drugs are largely driven by the increasingly burdensome cost sharing requirements imposed by insurance companies, not by an underlying increase in overall prescription drug costs – which remained below overall healthcare inflation last year. Patients typically pay much higher out of pocket costs for prescription medicines relative to other health care services like inpatient hospital care — 22 percent vs 4 percent, respectively, for privately insured patients.

“This disparity can lead to worsened health outcomes and higher overall healthcare costs as patients neglect to fill needed prescriptions that can avert the need for costly hospitalizations and other non-drug healthcare expenses.”

About BIO

BIO is the world's largest trade association representing biotechnology companies, academic institutions, state biotechnology centers and related organizations across the United States and in more than 30 other nations. BIO members are involved in the research and development of innovative healthcare, agricultural, industrial and environmental biotechnology products. BIO also produces the BIO International Convention, the world’s largest gathering of the biotechnology industry, along with industry-leading investor and partnering meetings held around the world. BIOtechNOW is BIO's blog chronicling “innovations transforming our world” and the BIO Newsletter is the organization’s bi-weekly email newsletter. Subscribe to the BIO Newsletter.

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June 19-22, 2017
San Diego, CA

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July 23-26, 2017
Montreal, Canada




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