Connecticut’s government employee health plan spends roughly $300 million a year on prescription drugs, and newly issued data details some of the biggest cost drivers in that figure.
The Office of Health Strategy (OHS) recently released several reports showing that antiarthritic medications Humira and Enbrel were the two outpatient drugs with the highest gross costs, both in 2019 and for the 2016-2019 period analyzed.
The legislature ordered the annual analysis from OHS in a 2018 law that took effect this year, seeking additional transparency into pharmacy costs.
In 2019, the total gross cost — the amount paid by the state’s insurance carrier plus any applicable out-of-pocket member costs — was $17.6 million for Humira and $7.9 million for Enbrel, according to the data, which CVS provides to OHS and the State Comptroller’s office.
From 2016 to 2019, Humira and Enbrel cost the state $58 million and $30.3 million, respectively.
Neither was the costliest drug on a per unit basis, however. In 2019, the priciest daily prescription treatment was an enzyme called Zenpep, at a unit price of $1,731, followed by Benefix, a bleeding prevention drug that cost the state $1,707 per day of treatment in the recent year.
OHS said it intends to issue more information than is specifically called for in the 2018 law.
“There’s a public benefit to having the costliest and most prescribed medications listed in one place at one time,” OHS Executive Director Vicki Veltri said in a statement. “The current listing is based on current law; going forward, additional and more complete reporting of a larger number of drugs would be ideal.”
Lawmakers in 2018 directed OHS to prepare a list of not more than 10 outpatient prescription drugs that the agency determines are provided at a substantial cost to the state, and to focus on drugs whose prices increased by 20% or more over the preceding year, or by 50% or more during the past three years. The law also says the list must cover different classes of therapeutic drugs, which excluded at least some of the costlier drugs that would have otherwise been on the list, OHS said.
Based on the legislature’s gross cost and price-change parameters, OHS said erectile dysfunction drug Cialis stood out among other medications, with its unit cost rising nearly 54% from 2016 to 2019, costing the state $17.8 million over that time.
However, Cialis’ unit price dropped sharply over the past year, from $6.9 million in 2018 to $2.4 million in 2019, due to a generic version of the drug hitting the market. The state bought $2.5 million worth of that drug, called Tadalafil, last year.
