Investor Presentaiton

Trends for 2021 did not follow this general pattern due to the high utilization of COVID-19 vaccines that were subsidized and made available at very low per unit prices. The Pfizer, Moderna, and Janssen COVID-19 vaccines were three of the four most prescribed immunological agents in 2021, with unit prices of approximately $40. Without the COVID-19 vaccines, per unit prices of brand name drugs would have certainly increased in 2021 as well. Leading Contributors to Prescription Drug Spending in the Commercial Market To gain a better understanding of what is driving prescription drug spending in the commercial market, OHIC reviewed the seven categories of drugs accounting for almost all of 2021 spending on brand name drugs. Immunological agents topped the list with spending at $177 million (see Exhibit 3.4). A deeper look at leading immunological agent brand drugs shows that per unit prices and annual increases Exhibit 3.4: Commercial Spending for the Top 20 Brand Name Drug Categories in 2021 Immunological Agents Blood Glucose Regulators Antineoplastics Respiratory Tract/Pulmonary Agents Central Nervous System Agents Antivirals Blood Products and Modifiers Genetic, Enzyme, or Protein Disorder: Replacement, Modifiers, Treatment Gastrointestinal Agents Dermatological Agents Analgesics Antipsychotics Cardiovascular Agents Non-Medicinal Anticonvulsants Ophthalmic Agents Antidepressants Antibacterials Anti-Addiction/Substance Abuse Treatment Agents Contraceptives $0.0M $50.0M Source: OHIC analysis of HealthFacts RI data. Medicare fee-for-service data are excluded. 18 Annual Report: Health Care Spending and Quality in Rhode Island $100.0M $150.0M $200.0M

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