2015年6月1日，Express Scripts的新报告：去年花费在癌症药物的费用上涨了超过1/5，其中用量增加了9%，价格上涨12%。“罪魁祸首”是那些？Gleevec占了药房福利支出的12.5%，第二是Revlimid，占了10.8%，第三是Lupron Depot，第四Xeloda，第五Temodar。报告预测，未来癌症药物人将是支出的大头。

Novartis, Celgene meds take the biggest shares of cancer drug spending

Cancer drug spending is up. Cancer drug prices are way up. And as a new Express Scripts ($ESRX) report shows, spending on each cancer patient is mounting; it's among the reasons why a growing number of individual patients account for $100,000-plus in annual drug spending. And a few big drugs made big contributions to that rise.

As the American Society of Clinical Oncology meeting approaches, the pharmacy benefits manager released some numbers on cancer drug spending. The top line? Spending on cancer meds grew by more than one-fifth last year, with a 9% increase in use and almost 12% increase in prices.

Prime suspects for that increase? The leukemia treatment Gleevec, from Novartis ($NVS), which boasts the biggest share of the market at 12.5%. Fellow blood cancer treatment Revlimid--the multiple myeloma therapy from Celgene ($CELG)--came in close behind with 10.8% of pharmacy benefit spending.

In third place by market share is Lupron Depot, the AbbVie ($ABBV) med used to treat several conditions, including prostate cancer. And rounding out the top 5 were two newly generic chemotherapies, capecitabine, also sold by Roche ($RHHBY) under the brand name Xeloda; and temozolomide, the Merck & Co. ($MRK) pill Temodar that's used to treat brain tumors.

And the growth shows no sign of slowing, the PBM said in a blog post, partly because of new meds coming to market--including Pfizer's ($PFE) blockbuster-to-be breast cancer med Ibrance (palbociclib), Novartis' myeloma med Farydak (panobinostat) and Eisai's thyroid cancer treatment Lenvima (lenvatinib). Not to mention the PD-1/PD-L1 immunotherapies that are swiftly racking up data (and approvals) in multiple cancers, including Merck's Keytruda and Bristol-Myers Squibb's ($BMY) Opdivo.

"Express Scripts expects cancer medications will maintain their lead position as a major contributor to drug spending in the pharmacy benefit, due to the availability of new medications and increased survival requiring long-term use of expensive and complex treatment," the PBM notes.

That's why Express Scripts is so keen on negotiating discounts with drugmakers, including pay-for-performance deals that would peg prices to results. It's also why Express Scripts is impatiently waiting for--and lobbying on the behalf of--biosimilar meds. The PBM says 11 biosimilars closest to FDA approval could save the healthcare system $250 billion over the next decade. That would include Roche's Avastin (bevacizumab) and Herceptin (trastuzumab), two of the top-selling cancer meds on the planet.