Volume Fueling Rise in Part D Specialty Derm Drug Spending
Harvard Medical School researchers reported that from 2013 to 2022, prices were higher and rose faster for specialty medications, but that 80% of the increase in spending 'was due to increased prescriptions, not prices.'
Price increases only accounted for 20% of the total growth in Medicare Part D dermatologic drug spending during the study period, lead author Edward L. Kong, PhD, told Medscape Medical News .
Specialty medications — primarily immunomodulators — 'are just very expensive in general,' and are being rapidly adopted by clinicians, which is driving increased spending, said Kong, who is pursuing an MD degree at the Harvard-MIT Health Sciences and Technology program.
Kong and Arash Mostaghimi, MD, MPA, MPH, medical director of the dermatology consult service at Brigham and Women's Hospital, and associate professor, Harvard Medical School, both in Boston, published their findings in JAMA Dermatology on July 16.
They examined some 95 million prescriptions for Medicare beneficiaries, written by almost 25,000 dermatologists and dermatology-focused advanced practice clinicians. Inflation-adjusted spending increased an average of 16% a year, reaching $2.95 billion in 2022. Over the study time period, specialty drug spending increased just under 30% a year, reaching $2.4 billion in 2022. Spending on nonspecialty medications only grew 0.7% annually during the study period.
By 2022, specialty medications accounted for 81% of all dermatology drug spending, having risen from a third of spending in 2013. Even so specialty medications only represented about 3% of all Medicare Part D dermatology prescriptions in 2022.
Four of the specialty drugs were introduced before 2013: adalimumab (Humira), etanercept (Enbrel), ustekinumab (Stelara), and vismodegib (Erivedge). Six came on the market after 2013: apremilast (Otezla), secukinumab (Cosentyx), ixekizumab (Taltz), dupilumab (Dupixent), guselkumab (Tremfya), risankizumab-rzaa (Skyrizi), and sonidegib (Odomzo).
The older medications had higher price growth than the six newer therapies during the study period. Humira, at the high end, had a 12% price increase per year, while Skyrizi, at the low end, had a 5% yearly decrease.
It's possible that biosimilars for Humira and Stelara — introduced in 2023 and this year — might help restrain cost growth, wrote Kong and Mostaghimi. The introduction of generic oral JAK inhibitors such as tofacitinib may also put a dent in spending, they noted.
Medicare will also likely achieve cost savings in 2026 on Enbrel and Stelara, which are included as part of a law — the Inflation Reduction Act— that gave the health program the power to negotiate prices of certain medications. Patients for affordable drugs now estimate that list prices for Enbrel will drop from around $7000 to $2355 and for Stelara from $13,836 to $4695.
The study did not examine the value of the high-cost specialty drugs, but the rise in prescriptions — indicated by each of the 10 achieving a 1% market share — shows that the medications are being embraced, wrote Kong and Mostaghimi.
The authors' work is similar to other studies that have documented major increases in Medicare Part D dermatologic drug spending being driven in part by increased adoption of specialty medications. A 2022 study in the Journal of the American Academy of Dermatology found that from 2013 to 2019, the price of six dermatology drugs in the top 10 most-prescribed medications decreased, mostly among nonspecialty medications. But in 2013, Enbrel was the most expensive medication in the top 50 most prescribed. Enbrel had been replaced in 2019 by Humira.
In 2020, researchers reported in the Journal of Dermatological Treatment that annual spending on immunomodulator medications by Medicare Part D increased 303% from $1.7 billion in 2012 to $6.9 billion in 2018. 'Immunomodulator spending is growing and may be more substantial than previously reported posing significant burden on patients and the health system,' the authors wrote.
Kong and Mostaghimi agreed, writing that 'the growing significance of specialty medications will have important implications for healthcare costs and patient affordability.'
Kong reported receiving grants from the National Institute on Aging. Mostaghimi reported receiving personal fees from Hims & Hers Health, AbbVie, Sun Pharma, Digital Diagnostics, Eli Lilly, Equillium, ASLAN Pharmaceuticals, Boehringer Ingelheim, Figure 1, Indomo, Olaplex, Legacy Healthcare, Pelage, Q32 Bio, Astria Therapeutics, ACOM Health, Bioniz, Concert, and Digital Diagnostics; equity from ACOM Health, Figure 1, and Hims & Hers Health; licensing or royalties from Concert and Pfizer; and research funding from Aclaris, Concert, Eli Lilly, and Incyte outside the submitted work.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
21 minutes ago
- Yahoo
This Personality Trait Might Be the Key to a Longer, Healthier Life
As a society, we're not as trusting as we used to be—for good reason. We're living at a time of internet scams, catfishing, artificial intelligence, and social media, where you really don't know what to believe. But a new study suggests that being more trusting may actually have its benefits. Published recently in the American Psychological Association's journal Psychological Bulletin, the research found that people with higher levels of trust in both other people and institutions have higher levels of well-being than those who aren't as trusting. This is especially important, the authors argue, as well-being is not only an indicator of quality of life, but also a predictor of health and longevity. So, what does it take to become more trusting? And how do you strike a balance between trust and caution? We spoke with a number of experts to find out. Why Does Trust Improve Well-Being? The study found that people who feel they can rely on others—whether it's close relationships or the broader systems around them—tend to experience lower stress, stronger emotional regulation, and a greater sense of safety in the world, says Dr. Sanam Hafeez, PhD, neuropsychologist and director of Comprehend the Mind. 'All of these factors support not just mental wellness but also physical health,' she explains. 'The absence of trust leaves people more prone to feeling alone, hypervigilant or anxious, and over time, chronic stress triggers the body's stress response. Studies have shown connections between chronic stress and inflammation, cardiovascular disease, lowered immunity, and even cognitive decline.' In contrast, trusting others may provide a protective benefit, lowering cortisol levels and buffering behaviors associated with long-term health like remaining socially connected, seeking medical care when needed, and sticking to healthful routines, Hafeez says. 'Trust isn't just a pleasant emotion, it's a potent psychological resource,' she explains. 'When nurtured over the course of a lifetime, it can contribute to both emotional resilience and physical longevity.' Additionally, the study shows that the most important kind of trust is interpersonal (involving our family and friends), which has the strongest positive link to our well-being. 'With clients, one of the most important protective factors that can help with their healing process is having access to strong and positive social support systems, which is what this study confirms,' says Patrice Le Goy, PhD, licensed marriage and family therapist. The study also notes trust is particularly important for older adults who may need to rely on—and trust—people more as they become limited in some activities, Le Goy points out. 'If they have these positive relationships where there is a strong sense of trust, they have higher levels of happiness and life satisfaction,' she says. How Can We Increase Our Trust in Other People? Despite the benefits, being more trusting of others can be a challenge, especially if people or institutions have broken your trust in the past. Fortunately, there are ways to help you become more trusting of others. Here are some tips from mental health experts. Start Small According to the study, trust can change based on our experiences and environment. According to Cynthia Vejar, PhD, professor of clinical mental health counseling at Lebanon Valley College, building trust starts small, in the presence of everyday initiatives and routine moments. For example, if a person has difficulty with trust, they might begin by noticing that their colleagues are reliable and dependable by showing up on time, following through on commitments, and working collaboratively. 'These kinds of observations can be reassuring and allow the person to begin to open up to deep and meaningful interactions elsewhere,' Vejar says. Hafeez recommends observing how people show up over time. 'Do their actions match their words, do they listen without judgment, do they respect your boundaries?' she asks. 'Trust grows when people demonstrate reliability in small, everyday ways.' Understand There's Risk Involved Increasing trust with others is all about taking small, calculated risks, says Hannah Holmes, PhD, licensed clinical psychologist and founder of Holmes Psychology & Consulting. 'There is always the possibility that others might hurt us or let us down, and this feels especially real if you have experienced a lot of that in your history,' she says. Shift Your Mindset Trusting others can be challenging and requires intentional mindset shifts, changes in our perspective, and continuous monitoring of our mood and self-regulation, says Tori Broems, PhD, licensed psychologist. 'People's well-being influences the way they perceive the world around them,' she says. 'Essentially, our perception of reality holds tremendous weight. When we are happy and positive, we are more trusting, whereas when we are negative and frustrated, we feel less likely to trust others.' Examine Why You Have a Hard Time With Trust Often people who have a difficult time trusting people have good reasons for feeling this way—they've probably been let down by people in their past who they wanted to trust, Le Goy says. 'The work is often in acknowledging and validating that fact first, and understanding our reasons for behaving the way we do,' she explains. 'Once we do that, then we can make sure that we are not using these past hurts to project on people who didn't cause that pain.' Le Goy often asks clients, 'Does this past pain belong in this current relationship?' 'This allows us to consider that we can be safe now even if we have been unsafe in the past,' she says. 'It's actually about helping us trust ourselves more—that we can make good decisions, and we can see if the person in front of us is trustworthy. Only then can we truly increase our trust in other people.' Stay in the Present Hafeez stresses the importance of staying grounded in the present rather than assuming someone new will behave like someone from your past. 'That takes self-awareness and patience, but it is possible,' she says. 'It also helps to strengthen your emotional boundaries. When you know you can speak up, walk away, or protect your peace, you feel less anxious about giving people a chance.' Give People a Chance to Show They're Trustworthy While it makes sense to practice some caution and not share everything with someone you've just met, you should at least give them the opportunity to demonstrate their trustworthiness, Holmes suggests. 'This could look a lot of different ways, ranging from sharing an embarrassing story to delegating a low-stakes task to someone else,' she says. 'Trusting others with small things gives them the opportunity to demonstrate trustworthiness, which in turn will help you build your trust in that person. It's okay for this process to take a little time.' How Can We Strike a Balance Between Trust and Caution? Trust is like a muscle that you build over time, Le Goy says. This involves trusting yourself and listening to your gut when something feels 'off.' Instead of blindly trusting—or distrusting—someone, Broems suggests trying realistic trust-building. Ask yourself whether this person follows through. Do their actions match their words? Can they handle your boundaries respectfully? 'You don't have to trust fast—just slowly building this over time can be helpful,' she says. Striking the right balance between trust and caution might mean that the person starts off more discerning, and with time, they become more open and trusting, Vejar says. 'It is important to note that 'discernment' is different from 'cynicism,' the latter of which might prevent the development of trust,' she explains. 'While both discernment and cynicism involve caution and protection, discernment is more observant—open to information as it unfolds—and cynicism is more suspicious and negative.' Ultimately, striking a healthy balance between trust and caution means learning to stay open without being naive, Hafeez says. 'It is not about trusting everyone equally, it is about being emotionally available while also using discernment,' she says. 'Trust should be something people earn through their actions—not something you give away all at once.' Read the original article on Real Simple
Yahoo
29 minutes ago
- Yahoo
Physicists Blast Gold to Astonishing Temperatures, Overturning 40 Years of Physics
Physicists superheated gold to 14 times its melting point, disproving a long-standing prediction about the temperature limits of solids Gold usually melts at 1,300 kelvins—a temperature hotter than fresh lava from a volcano. But scientists recently shot a nanometers-thick sample of gold with a laser and heated it to an astonishing 19,000 kelvins (33,740 degrees Fahrenheit)—all without melting the material. The feat was completely unexpected and has overturned 40 years of accepted physics about the temperature limits of solid materials, the researchers report in a paper published in the journal Nature. 'This was extremely surprising,' says study team member Thomas White of the University of Nevada, Reno. 'We were totally shocked when we saw how hot it actually got.' The measured temperature is well beyond gold's proposed 'entropy catastrophe' limit, the point at which the entropy, or disorder, in the material should force it to melt. Past that limit, theorists had predicted solid gold would have a higher entropy than liquid gold—a clear violation of the laws of thermodynamics. By measuring such a blistering temperature in a solid in the new study, the researchers disproved the prediction. They realized that their solid gold was able to become so superheated because it warmed incredibly quickly: their laser blasted the gold for just 45 femtoseconds, or 45 quadrillionths of a second—a 'flash heating' that was far too fast to allow the material time to expand and thus kept the entropy within the bounds of known physics. 'I would like to congratulate the authors on this interesting experiment,' says Sheng-Nian Luo, a physicist at Southwest Jiaotong University in China, who has studied superheating in solids and was not involved in the new research. 'However, melting under such ultrafast, ultrasmall, ultracomplex conditions could be overinterpreted.' The gold in the experiment was an ionized solid heated in a way that may have caused a high internal pressure, he says, so the results might not apply to normal solids under regular pressures. The researchers, however, doubt that ionization and pressure can account for their measurements. The extreme temperature of the gold 'cannot reasonably be explained by these effects alone,' White says. 'The scale of superheating observed suggests a genuinely new regime.' [Sign up for Today in Science, a free daily newsletter] To take the gold's temperature, the team used another laser—in this case, the world's most powerful x-ray laser, which is three kilometers (1.9 miles) long. The machine, the Linac Coherent Light Source at the SLAC National Accelerator Laboratory in California, accelerates electrons to more than 99 percent the speed of light and then shoots them through undulating magnetic fields to create a very bright beam of one trillion (1012) x-ray photons. When this laser fired at the superheated sample, the x-ray photons scattered off atoms inside the material, allowing the researchers to measure the atoms' velocities to effectively take the gold's temperature. 'The biggest lasting contribution is going to be that we now have a method to really accurately measure these temperatures,' says study team member Bob Nagler, a staff scientist at SLAC. The researchers hope to use the technique on other types of 'warm dense matter,' such as materials meant to mimic the insides of stars and planets. Until now, they've had no good way to take the temperature of matter in such toasty states, which usually last just fractions of a second. After the gold trial, the team turned its laser thermometer on a piece of iron foil that had been heated with a laser shock wave to simulate conditions at the center of our planet. 'With this method, we can determine what the melting temperature is,' Nagler says. 'These questions are super important if you want to model the Earth.' The temperature technique should also be useful for predicting how materials used in fusion experiments will behave. The National Ignition Facility at Lawrence Livermore National Laboratory, for example, shoots lasers at a small target to rapidly heat and compress it to ignite thermonuclear fusion. Physicists can now determine the melting point for different targets—meaning the whole field could be heating up in the near future. Solve the daily Crossword
Yahoo
39 minutes ago
- Yahoo
Neuralink targets $1 billion revenue by 2031, Bloomberg News reports
(Reuters) -Elon Musk's brain implant company Neuralink aims to generate at least $1 billion in annual revenue by 2031, driven by plans to perform 20,000 surgeries per year, Bloomberg News reported on Wednesday, citing investor documents. The company aims to operate five large clinics within six years and offer three versions of its brain device, including Telepathy for communication between the brain and machines, Blindsight for restoring vision, and Deep for treating tremors and Parkinson's disease, according to the report. Neuralink did not immediately respond to a Reuters request for comment. The company expects regulatory approval for its Telepathy device by 2029, with plans to perform 2,000 surgeries annually and generate $100 million in revenue, the report said. By 2030, Neuralink anticipates launching Blindsight, expanding surgeries to 10,000 per year and generating over $500 million in revenue. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
