Humira continued to be the costliest prescription drug for self-funded health plans in 2023 by a comfortable margin, according to a recent Milliman commercial drug trends review. Used to treat a variety of conditions from Crohn’s to rheumatoid arthritis and psoriatic arthritis, Humira cost $145,002 per 1,000 lives in 2023 – over $55,000 more than second-place finisher Ozempic.
But whether Humira will maintain its top position is an open question. As the report observes, “[t]he market share of Humira compared to its biosimilars is currently in a tenuous position, as manufacturers fiercely compete for preferred formulary positioning with pharmacy benefit managers (PBMs).” MedBen currently offers the Humira biosimilar Idacio at a substantially reduced price, which will save clients nearly $3.3 million in 2024.
Equally noteworthy is that glucagon-like peptide-1 (GLP-1) drugs used to treat diabetes and obesity have gained ground. Four GLP-1s – Ozempic, Trulicity, Mounjaro, and Wegovy – are represented on the 2023 Top Drugs by Cost list, compared to just two the prior year (see chart below). Ozempic leapfrogged Stelara to take the number two spot.
Overall trends include (per Benefits Pro):
- Employers filled 3% fewer prescriptions in 2023… on average, 1.3 30-day prescriptions per month.
- The average cost of a prescription rose from $130.57 in 2022 to $142.65 in 2023 – a 9.3% increase.
- The most commonly used drug is atorvastatin calcium, an anti-cholesterol medication. Health plans paid for 522 atorvastatin calcium prescriptions per 1,000 members.
Milliman estimates that the overall average wholesale price (AWP) of drugs will increase between 13% and 17% annually among commercial plans from 2023 to 2025.