2018 Annual Drug Trend Report

Better health is only possible when medications are accessible and affordable. Our annual Express Scripts Drug Trend Report is the industry’s most comprehensive and influential examination of year-over-year changes in the cost and use of prescription medications in the U.S.

2018 Drug Trend Report: 5 key takeaways

In 2018, Express Scripts helped tens of millions of people get the most value for each dollar spent on prescription drugs by ensuring each individual gets the right medicine at the right time at the right cost.

1. Achieved industry-lowest 0.4% trend for employers

For employer-sponsored plans, the annual increase in drug spending in 2018 was the lowest we have seen in a quarter century. We also reduced spending for 50% of employers and delivered an unprecedented 0.3% decline in spending for Medicare plans.  

Total trend for commercial plans, 2016 - 2018

2. Saved clients $45B through clinical solutions

Here’s just one example. Plans enrolled in the Diabetes Care ValueSM program – part of our innovative SafeGuardRxSM solutions – had a 4.3% decrease in spending for diabetes medications, compared with a 7.5% increase in spending for plans not enrolled.

3. Reduced the impact of brand list price inflation

While prices of the most commonly used brand drugs increased 7.3% in 2018, our employer-sponsored plans saw unit costs decline 6.5% for traditional drugs and increase just 2.1% for specialty drugs. Traditional drug costs also decreased 5.5% for Medicare plans and 5.6% for exchange plans.

4. Decreased opioid utilization 16.6%

Days’ supply for first-time opioid prescriptions dropped 55% for people enrolled in our Advanced Opioid Management solution. In fact, 93% of patients who were prescribed more than a 7-day supply had their quantities reduced.

5. Held 30-day Rx cost to only 6¢ more than in 2017

Patients in employer-sponsored plans paid just 15% of the total prescription costs in 2018. The average patient out-of-pocket costs for a 30-day prescription, on average, was $11.55 – just 6 cents more than 2017.

10-year trend for commercial plans, 2009 - 2018

Looking ahead

We’re creating a sustainable future for plan sponsors while improving access for patients, yet our work is not done. We’re doubling down on our focus on better outcomes, and making health care more personal, affordable, accessible – and simpler for all.

About the report

We analyzed the de-identified prescription drug use data of approximately 34.2 million people with a pharmacy benefit plan administered by Express Scripts, including those in an employer-sponsored, Medicare, Medicaid or health insurance exchange plan.

Public Policy Analysis

In a companion report that reviews drug spending trends and public policy, Express Scripts once again calls upon stakeholders to act on a prescription drug affordability agenda.