Becker's Hospital Review

21 CFO / FINANCE Hospital drug spending will go up 3% next year, Vizient predicts By Maia Anderson T otal pharmaceutical spend for hospitals and health systems will in- crease by 3.1 percent in 2022, Vizient projected in its pharmacy market outlook, released July 28. Vizient, a healthcare services company and group purchasing organization, developed its pharmacy market outlook by analyzing its member hospi- tals' pharmaceutical purchase data. The data analysis period was April 2020 through March 2021. Five predictions from the report: 1. Oncology will remain the top therapeutic class in spend. Oncology medica- tions make up nearly 25 percent of Vizient hospitals' spend, and total oncolo- gy drug spend will increase by 3.25 percent in 2022 as more new molecular entities are approved by the FDA. 2. Adalimumab, a rheumatoid arthritis drug, will continue to be ranked first in terms of spending until it faces biosimilar competition. 3. Spending on diabetes drugs such as insulin will increase by 2.63 percent in 2022. Health systems are expected to use more diabetes drugs as more people are being diagnosed with the condition. 4. Specialty drug spend will grow by 4.68 percent as a greater number of specialty drugs are approved by the FDA. 5. The evolving COVID-19 pandemic will play a big role in determining hos- pitals' drug purchases. During the data analysis period, remdesivir made up the third-highest drug spend overall among Vizient hospitals and was the No. 1 infectious disease-related medication. n Anthem, Dignity Health reach multiyear contract By Nick Moran A nthem and San Francisco-based Dignity Health announced a new mul- tiyear agreement in August, about a month after their previous con- tract expired. The new agreement is retroactive to the July 15 expiration date of the pre- vious contract, meaning care received during the time between contracts is considered in network, according to an Aug. 16 news release. Patients who sought care at other facilities have the option to return to Dig- nity, and those who issued continuity of care forms to Anthem can proceed normally. The nearly 30 Dignity hospitals throughout California were affected by the previous contract termination, as well as organizations like University of Cali- fornia Santa Cruz. n Bankrupt New Jersey health plan says it can't pay out medical claims By Alia Paavola A bankrupt self-insured health plan for 2,500 physician practices and other small businesses said it doesn't have enough money to pay out medical claims, nj.com reported Aug. 19. Affiliate Physicians & Employers Master Trust, which filed for bankruptcy in May, said that it will need a bailout from policyholders to help pay its debts. Companies insured by the trust are expected to pay their share of the debt. e share will be determined based on a percentage of claims submitted from January to July, according to the report. e trust said it filed for bankruptcy this spring because of increased pandemic-related costs, including testing and treatment claims. e trust said it owes about $10 million. In July, the trust asked the New Jersey gover- nor for $18 million in pandemic relief funds, saying the money would have allowed the trust to pay its debts and maintain a surplus required to continue operating as a health plan in the state. e governor didn't re- spond to the request, according to the report. "Unfortunately in the coming weeks, the rev- enue … will not be sufficient to reimburse Aetna for the claims that it is paying on be- half of the employees of the members. ere- fore we regretfully must advise that there likely will be interruptions in the payment of employee medical claims," a July 20 letter sent on behalf of the bankrupt health plan reads. "rough the assessment and other ef- forts, we hope to be in a position where ulti- mately all employee medical claims are paid." e trust is a multiple employer welfare arrangement, an alternative to traditional group plans. ey are oen cheaper because they aren't required to pay into a fund that protects policyholders if the health plan is unable to meet its financial obligations. n

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