Cost Trends to Skyrocket for Specialty Prescription Drugs, Annual Segal Health Plan Cost Trend Survey Forecasts

Business Wire

Specialty Drug Trend Increases of 15% are Expected for Many Essential Prescriptions, Including Chemotherapy Medications

NEW YORK--(BUSINESS WIRE)-- The 2020 Segal Health Plan Cost Trend Survey reveals that health plan cost trends continue to outpace both overall inflation and wage growth, and a key driver is the price of specialty drugs. Actual trend for preferred provider organization (PPO) plans went up by 196% from 2009 to 2018, not including prescription drug coverage. The 2020 survey marks The Segal Group’s 23^rd survey of managed care organizations (MCOs), health insurers, pharmacy benefit managers (PBMs) and third-party administrators (TPAs).

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Specialty Drugs Skyrocketing Says Segal Annual Health Plan Cost Trend Survey (Graphic: Business Wire)

More than 100 health insurance carriers participated, reporting 2020 trend forecasts for medical, prescription drug, dental and vision coverage and actual 2018 health cost trends based on their group health plan experience. Survey respondents collectively represent more than 80% of the commercially insured and self-insured market. This survey is known as one of the most definitive surveys on employer-sponsored health plans, and the survey report also provides insights on how plan sponsors can tackle growing health costs.

“Many organizations are leaving money on the table because they don’t take full advantage of cost containment tools,” said Edward Kaplan, National Health Practice Leader, The Segal Group. “Companies that take a proactive approach in managing their health plans can keep their annual increases substantially below the industry average. When health plan sponsors engage in custom networks, value-based arrangements, and clinical programs that align with the health condition that drive their plan costs, they find it’s time and energy well spent.”

Segal is also seeing an increase in interest in leveraging cost and quality data by provider to potential remove outlier network providers that charge excessive fees for similar clinical outcomes. Another factor driving positive change in health and benefits cost management is the use value based pharmacy benefit formularies, where high cost, low value medications are removed from coverage.

“Segal has created proprietary data mining technology that takes a deep dive into current and past data that has helped clients save millions of dollars,” said Eileen Flick, Senior Vice President and Director of Health Technical Services, The Segal Group. “The 2020 Segal Health Plan Cost Trend Survey shows that greater health care quality and cost transparency are top cost-management strategies for plan sponsors and it’s important to use all the innovative tools available as health costs continue to rise.”

To interview one of Segal’s health consulting leaders, contact: Amira Rubin at arubin@segalco.com.

The Segal Group provides trusted advice that improves lives. Segal is a privately-owned benefits, compensation and investment consulting firm with more than 1,000 employees throughout the U.S. and Canada. Members of The Segal Group include Segal Consulting, Sibson Consulting, Segal Select Insurance Services, Inc. and Segal Marco Advisors