Investor Presentaiton
are typically lower priced than brand name drugs, but the cost of generics has also been rising. Figure 9
demonstrates the disparate share specialty drugs have on total drug expenditures at one CCO.
Figure 9: Two thirds of Medicaid prescription drug spending is for specialty and brand name drugs, despite
comprising only 5% of claims
% Claims ■% Spending
0.4%
Specialty drugs
33%
Brand drugs
5%
Generic drugs
20%
33%
90%
0%
20%
40%
60%
80%
100%
Source: OHA and PBM data
Specialty drugs make up less than 1% of prescriptions but are one-third of total prescription drug spending.
The amount of prescription drugs claims is increasing because the prevalence of chronic conditions has
increased with the aging of the U.S. population and because new therapies and generic drugs have
become more available. In the past several decades, the country has seen large growth in medications
treating common conditions, such as high blood pressure, high cholesterol, anxiety, and depression.
However, the number of generic drugs may not increase as much as brand and specialty drugs in the
future due to the likelihood of newer brand and biologic drugs and the current extensive use of
generics. Biologic drugs are complex and harder to manufacture than traditional prescription drugs.
Figure 10 details some of the most expensive drugs, in total, CCOs paid for in 2021.
Oregon Secretary of State Report 2023-25 | August 2023 | page 10View entire presentation