In telling its member hospitals what price inflation to expect during calendar-year 2018, Vizient also highlights the special concerns of hospital pharmacies in the general mix of pharmaceutical purchasing. High on its list are:
- the slow introduction of biosimilars
- the expanding universe of high-priced orphan drugs
- the continuation of drug shortages
- the concerns over compounded pharmaceutical products, whether produced internally or outsourced.
The forecast, based on recent contracting data from Vizient suppliers combined with industry data, indicates that autoimmune drugs will continue with double-digit inflation, rising by 14.8%, while contracted products (mostly generics) will rise by only 0.46%. “Future opportunities for generic savings will be fewer and potentially less significant than in the past, given the prevalence and influence of biologics across the top-spend drugs for hospitals, health systems, and clinics,” the report says, while looking to an acceleration of biosimilar introductions.
Drug shortages have declined since a peak year of 2011, but still remain elevated above the levels seen during the 2000’s. During this year, shortages have cropped up among very basic—but essential—products such as sodium bicarbonate or intravenous saline and dextrose. Hospital pharmacies scramble to obtain sufficient stocks of these drugs, adding to pharmacy costs.
On the compounding front, Vizient notes that USP <797> and related standards call for tighter control of the compounding workspace; at the same time, the compounding of high-potency drugs creates workplace hazards if not properly managed. (One means to address this is automated compounding equipment, which is seeing uptake in hospital pharmacies.)
“The latest Drug Price Forecast highlights numerous market dynamics that continue to contribute to rising pharmaceutical costs and exacerbate the challenge of managing health system pharmacy expenses,” said Dan Kistner, SVP, pharmacy solutions for Vizient. “Pharmacy leaders – now more than ever – must be proactive and strategically plan to address these issues and implement cost-saving and quality optimization measures.”