Blue Cross Reports Some Success with Generic Drug Fill Rate while Nationwide, Branded Prescription Drug Prices Outpace Generics

Nov. 14, 2018

BATON ROUGE – Prescription drug spending among branded specialty and patent-protected drugs continues to outpace generic drugs by $79.5 billion, according to an update to last year’s study of medical claims by the Blue Cross Blue Shield Association (BCBSA). At more than $100 billion, prescription drugs represent more than 20 percent of overall healthcare spending for all Blue Cross and Blue Shield commercially insured members. 

“Accountability and transparency are key to developing a better understanding of overall healthcare costs, particularly the cost of prescription drugs that are essential to maintaining a person’s health,” said Maureen Sullivan, Chief Innovation and Strategy Officer, Blue Cross Blue Shield Association. “The report findings underscore the underlying cost drivers in the prescription drug market and identify potential surges in overall drug costs in the future."

One long-recognized strategy to contain prescription drug costs is to encourage the use of lower-cost, yet effective generic drugs. Blue Cross and Blue Shield of Louisiana reports that its generic fill rate is 87 percent—four points higher than BCBSA’s reported 83 percent national average for the same time period. 

“Without appropriate coverage strategies that encourage use of lower cost yet highly effective drugs, spending could be a lot higher,” says Milam Ford, pharmacist and vice president of Pharmacy Services at Blue Cross and Blue Shield of Louisiana.

“Our top priority is to make sure that healthcare is affordable, so that people can access the care they need to get healthy and stay healthy,” says Ford. 

Blue Cross and Blue Shield of Louisiana claims data for fully insured members show brand drugs make up 12 percent of total prescriptions yet account for 36 percent of overall drug spending. 

Further, Blue Cross and Blue Shield of Louisiana data show specialty drugs make up 1 percent of total prescriptions and account for 38 percent of overall drug spending. 

The BCBSA report, which encompasses eight years of drug utilization, price changes and overall spending, examined why the rise in use of generic drugs has been unable to contain the overall cost increase for branded prescription drugs. 

Some of the findings include:

  • More expensive branded prescription drug spending is up 4 percent since 2016. Branded prescription drugs comprise only 17 percent of total prescriptions filled but account for 79 percent of overall drug spending at $79.5 billion.
  • Steady annual increases in branded patent-protected prescription costs drive the majority of spending in the branded drug space, growing 5 percent in the past year alone. 
  • The growing market share of inexpensive generic drugs continued to slow the increase in total drug spending. While generic drug spending has declined 3 percent since 2016, it hasn’t kept pace with the rapid rise in specialty branded drugs. 

The Blue Cross Blue Shield Association also published a list of the top medications by spending during 2017 across the Blue system. It’s worth noting that the top three drugs on the list are used to treat autoimmune disorders.

  • Humira®
  • Remicade®
  • Enbrel®  
  • Novolog®
  • Neulasta®

The Prescription Drug Cost Trends Report is the 22nd study of the Blue Cross Blue Shield: The Health of America Report® series, a collaboration between BCBSA and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and insights in healthcare affordability and access to care. 

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  • Medical claims for 41 million commercially insured BCBS members were reviewed for this analysis, but the raw number that is written is an extrapolation to account for the 88 million members who currently have BCBS commercial coverage. 
  • Pharmacy claims were used to estimate total spending and utilization. 
  • Humira®, Remicade®, Enbrel®, Novolog®, and Neulasta® are the property of their respective owners, which are in no way associated or affiliated with the Blue Cross and Blue Shield Association.

About Blue Cross Blue Shield Association
The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for one in three Americans. BCBSA provides healthcare insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube or follow us on Twitter.

About BHI

Blue Health Intelligence (BHI) is the nation’s premier resource for data-driven insights about healthcare trends and best practices, promoting healthier lives and more affordable access to safe and effective care. BHI leverages a team of analytics experts and advanced technology, coupled with access to the greatest number of healthcare claims—172 million lives—gathered over 10 years in a safe, HIPAA-compliant, secure database. The resulting conformed, reliable data set has the broadest, deepest pool of integrated medical and pharmacy claims, reflecting medical utilization in every ZIP code. Blue Health Intelligence (BHI) is an Independent Licensee of the Blue Cross Blue Shield Association. BHI is a trade name of Health Intelligence Company, LLC. 

About Blue Cross and Blue Shield of Louisiana

Blue Cross and Blue Shield of Louisiana is committed to our mission to improve the health and lives of Louisianians. We invest both time and money in the communities we serve, supporting the health and wellbeing of Louisianians through more than 200 charitable organizations.

With our subsidiaries, HMO Louisiana and Southern National Life, we provide group and individual health insurance plans, life and disability insurance, group voluntary products and administrative services to one out of four Louisiana residents. Blue Cross and Blue Shield of Louisiana also provides Medicare supplement and Medicare Advantage plans and is a partner in offering the Healthy Blue Medicaid Managed care plan. Louisiana is the only state where we operate, with offices in every major region to serve our customers.

Founded in New Orleans in 1934, Blue Cross and Blue Shield of Louisiana is a tax-paying non-profit health insurer. We are a private mutual company, owned by our policyholders, with an independent Louisiana Board of Directors and no shareholders. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association.

To learn more, visit our website at or connect with us on our social media accounts.