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      TrendLens

      A focused look at book of business data

      Our purpose at CVS Caremark is optimizing drug spend for our clients, while improving health outcomes for their plan members.

      We generate and analyze data to assess our performance and keep clients informed. TrendLens is a closer look at selected data points from our book of business that illustrate larger trends in the pharmacy benefits space.

      Q1 | 24

      SPECIALTY TREND

      2.1%

      Specialty trend

      8.9%

      Utilization increase

      -6.8%

      Price growth

      50%

      Specialty as a share of overall spend

      FOCUS ON SPECIALTY

      Specialty trend hits its lowest point in recent history

      As a result of CVS Caremark’s continued concentration on specialty cost management, specialty trend hit its lowest point in recent history in the first quarter of 2024. Clocking in at 2.1 percent, this indicates significant relief for plan sponsors who have seen trend as high as 12.9 percent in the past decade.

      Despite increased utilization in oncology, atopic dermatitis, psoriasis, and asthma, price growth in specialty was negative, at -6.8 percent. This was driven largely by improved autoimmune class rebates, which are lowering unit costs. Looking further into the year, the specialty pipeline includes some additions that could have an effect on trend, including a COPD indication for Dupixent.

      Specialty spend hit a second milestone during the quarter as well, achieving parity with non-specialty spend after having represented more than half for a number of years. Our integrated approach to traditional and specialty cost management means that our programs work together to optimize value. Integration helps connect care across every step in therapy to maximize savings and improve member outcomes.

       

      Historic specialty trend

       

      Historic specialty spend data showing the percentage of spend for specialty medications over the years. In 2017, the spend was 12.9%, which decreased to 11.0% in 2018, further decreasing to 9.3% in 2019. However, in 2020, the spend increased to 12.4%, followed by a significant decrease to 6.7% in 2021. The trend continued with a further decrease to 6.5% in 2022, 3.7% in 2023, and a significant drop to 2.1% in 2024.

      CVS Caremark Specialty Trend, 2017-2024.

      GLP-1 SPEND

      50+%

      Non-specialty spend on anti-obesity medications

      68%

      Client savings from low net cost + UM strategies

      GLP-1s dominate traditional spend

      It will come as a surprise to no one that spend on anti-obesity medications continues to climb. In the first quarter of 2024, this drug class accounted for more than half of spend in the non-specialty (traditional) category, driven largely by utilization. Key drivers included:

       

      Data on non-specialty spend for anti-obesity medications. Mounjaro accounts for 59% of the spend, followed by Wegovy at 28% and Zepbound at 22%. Ozempic represents 10% of the spend, while Jardiance accounts for 7%.

      Drugs driving GLP-1 spend

       

      Indeed, the exploding popularity of these drugs had an outsize effect on overall commercial trend during the quarter, which came in at 7.6 percent. Together with utilization for diabetes, GLP-1s drove 64 percent of trend. Had GLP-1 utilization remained unchanged, overall non-specialty trend for the quarter would have been just 2.7 percent.

      We work closely with our clients to make the right choices around coverage, cost, and care to ensure responsible utilization of these important medications, which can significantly reduce disease burden. Nearly 800 CVS Caremark clients adopted a GLP-1 smart logic edit in the first two months the offering was available.

      The source for data in this document is CVS Health Enterprise Analytics, unless otherwise noted. Adherence results may vary based upon a variety of factors such as plan design, demographics and programs adopted by the plan. Client-specific modeling available upon request. Savings will vary based upon a variety of factors including things such as plan design, demographics and programs implemented by the plan. CVS Health uses and shares data as allowed by applicable law, and by our agreements and our information firewall.​ This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Health.

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