By Lauren Flynn Kelly - January 5, 2012

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For our first issue of the New Year, Drug Benefit News surveyed a range of PBM executives, health plan pharmacy directors and consultants to get an idea of what’s on trend, where companies are putting their investment dollars and what’s keeping them up at night. You can find their answers in a series of “Outlook 2012” stories in tomorrow’s issue.

One of the topics I had anticipated would stir up the most conversation is the trend of limited pharmacy networks, which was getting a lot of buzz this time last year. And it did get people talking, but not in the way I was expecting. Sure, some sources claimed these restricted networks are still on the rise and will become a benefit design widely used by employer clients. Yet others wondered if that trend will fade before it blows up. Either way, narrow networks have definitely gotten the attention of employers, and I think it’d be interesting to find a case study of an employer including this in their request-for-proposals in 2013. What would be their criteria? What would make them choose one set of pharmacies over another? If anyone has a lead, feel free to email me at lkelly@aishealth.com. Also, if you're not a DBN subscriber and you want to know what all the fuss is about, I'll send you a PDF of the Jan. 6 issue.

Another development that 2012 is bringing is that first wave of patent expirations, with health plans eagerly awaiting new generics in the antihypertensive and antipsychotic classes. As for what’s coming down the specialty pharmacy pipeline, new biologics were mentioned by only a couple sources, with excitement over biosimilars stealing their thunder. However, several experts agreed that the definition of and approval process for biosimilars makes for murky territory, warning that the difference in cost between biologic innovators and follow-on therapies will in no way be as substantial as that between traditional brand and generic drugs. With no hard data on cost at this time, however, plans may be better off focusing on new specialty therapies. So, if there any health plan or PBM execs out there who wish to discuss the SP pipeline, please give me a shout!

What do you see as the biggest pharmacy benefit trend in 2012?