Express Scripts Publishes Inaugural Drug Trend Quarterly, Provides First Comprehensive Overview of U.S. Prescription Drug

   Express Scripts Publishes Inaugural Drug Trend Quarterly, Provides First
      Comprehensive Overview of U.S. Prescription Drug Spending for 2012

-The Express Scripts Prescription Price Index shows that since September 2011,
price inflation for the most highly utilized brand-name medications was more
than six times greater than overall economic price inflation for consumer

-The price gap between brand-name and generic medications widened an
additional 35.2 percentage points from September 2011 to September 2012, the
largest one-year increase Express Scripts has recorded.

-Year-to-date spending on specialty medications is up 22.6 percent,
underscoring the nation's need for an accelerated pathway for biosimilars.

PR Newswire

ST. LOUIS, Nov. 28, 2012

ST. LOUIS, Nov. 28, 2012 /PRNewswire/ --Price inflation of branded
pharmaceutical drugs is far outpacing overall economic inflation, according to
new data released today by Express Scripts (NASDAQ: ESRX).


The Express Scripts 2012 Q3 Drug Trend Quarterly reviews year-to-date and
quarter-over-quarter changes in national drug spending for all major therapy
classes. The report is the first publication to reflect the combined data of
both Express Scripts and Medco.

According to the Express Scripts Prescription Price Index, prices on a market
basket of the most highly utilized brand-name medications increased 13.3
percent from September 2011 to September 2012, far outpacing the overall
economic inflation level of 2.0 percent. During the same timeframe, prices of
generic medications declined 21.9 percent. This 35.2 percentage point net
inflationary effect is the largest widening of brand and generic prices since
Express Scripts began calculating its Prescription Price Index in 2008.

"The patent cliff has fueled a growing price disparity between brand-name and
generic medications," said Steve Miller, M.D., chief medical officer at
Express Scripts. "The trend emphasizes the nation's continued need for the
tools we employ to help patients make better decisions, including generic use
when appropriate."

Drivers of Traditional Drug Trend

During the first three quarters of 2012, spending on traditional medications
decreased 0.6 percent over the same period in 2011, primarily driven by lower
prices brought on by increased use of generic medications.

The top traditional therapy class is mental and neurological disorders
(including antidepressants), which now consumes 24.7 percent of all
traditional drug spend. Although use of these medications has increased 3.1
percent compared to the first three quarters of 2011, total spending in this
class is down 1.9 percent due to newly available generic antidepressants and

Total spending on medications to treat high blood pressure and high
cholesterol decreased 7.7 percent, primarily driven by the continued impact of
patent expirations for blockbuster drugs.

Drivers of Specialty Drug Trend

Specialty drug trend continues its year-over-year double-digit growth. During
the first three quarters of 2012, spending on specialty medications increased
22.6 percent over the same period in 2011, primarily driven by unit cost
increases. In the first nine months of 2012, specialty drug costs consumed
20.8 percent of total pharmacy spend.

"The continued rise in spend on specialty medications underscores the nation's
need to accelerate the pathway for biosimilars," Dr. Miller said. "Additional
competition within these therapy classes would provide a necessary market
control against price inflation."

The three therapy classes representing the largest amount of specialty drug
spend continue to be rheumatoid arthritis/autoimmune conditions, multiple
sclerosis and cancer.

Medications commonly used to treat hepatitis C continue to have the largest
specialty spend increase, 117.3 percent over the same period in 2011.
Increased utilization is driving this trend, as new patients begin and
continue treatment with one of two new medications.

Eight of the nine notable new medications approved in the third quarter are
specialty medications. Many of these medications are second-line and
third-line drugs indicated to treat advanced cancers.

Spotlight on Obesity Medications

The report reviews the two new anti-obesity medications approved this summer
by the U.S. Food and Drug Administration. In clinical trials, many patients
taking either of the new medications lost at least 5 percent of their body

"The potential benefits of these new anti-obesity medications need to be
compared against their risks and cost," Dr. Miller said. "We are cautiously
optimistic about the possibilities of these and other drugs like them,
provided that they are prescribed appropriately and integrated with other
lifestyle modifying programs that help patients make healthier choices that
maintain their weight over time."

Methodology and Legacy

The Express Scripts Drug Trend Report was the first of its kind when initially
published in 1997. This year, by transitioning the report to a quarterly
publication, Express Scripts is providing more timely and actionable data to
its clients.

The inaugural quarterly report quantifies changes in utilization, unit costs
and overall prescription drug spending across the first three quarters of
2012, based on Express Scripts claims data for commercially-insured members.

The complete Drug Trend Quarterly is available at

About Express Scripts

Express Scripts (NASDAQ: ESRX) manages more than a billion prescriptions each
year for tens of millions of people. On behalf of our clients -- employers,
health plans, unions and government health programs -- we make the use of
prescription drugs safer and more affordable. We innovate to enhance patient
care, reduce pharmacy-related waste and increase therapy adherence. Building
on a strong clinical foundation, we apply our understanding of the behavioral
sciences -- an approach we call Consumerology® -- to make it easier for people
to choose better health.

Headquartered in St. Louis, Express Scripts provides integrated pharmacy
benefit management services, including network-pharmacy claims processing,
home delivery, specialty benefit management, benefit-design consultation,
drug-utilization review, formulary management, and medical and drug data
analysis services. The company also distributes a full range of
biopharmaceutical products and provides extensive cost-management and
patient-care services.

For more information, visit or follow @ExpressScripts
on Twitter.


David Whitrap
Office: 314-684-6514
Mobile: 314-517-3605

SOURCE Express Scripts

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