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Medical and pharmacy overall drug spend was primarily driven by utilization, inflation, and the arrival of new drugs on the market. On
the specialty side, the primary driver was utilization. Despite those influences, we kept our trends in the low-single digits — and even in the negative on the nonspecialty side. Those results stem directly from our dedication to keeping trend low without sacrificing value or access to clinically appropriate care. It’s a focus that’s rooted in our ability to provide integrated benefits across medical and pharmacy.

40% of our clients had a negative overall trend

40% of our clients had a negative specialty trend (medical + pharmacy)

2021

 

2021 trend summary

The continuing effect of COVID-19

The story of 2021 would not be complete without mentioning COVID-19 and how we helped manage it for our clients and members. COVID-19 has dominated everyday life for over two years. IngenioRx was no exception.

We carefully looked at the COVID-19 landscape to monitor the number of daily cases, hospitalizations, and vaccine rates. We also helped to ensure the clinically appropriate use of vaccinations by proactively implementing clinical criteria like age, quantity, and second-dose intervals. Our policies for COVID-19 vaccines and other therapeutics were consistent with clinical evidence and National Institutes of Health (NIH) guidelines and helped facilitate access to COVID-19 therapies. By following NIH guidelines, our efforts resulted in reduced hospitalizations and reduced total healthcare costs.

Vaccines were not the only bright spot on the COVID-19 landscape. The Food and Drug Administration (FDA) also approved the first drug for the treatment of COVID-19 in children and adults who require hospitalization.

As we look ahead, we will continue to carefully monitor the situation, including the use of oral antivirals
that became available. We have implemented clinical policies to help ensure that those medications are
used appropriately.

-1.7%

Nonspecialty

3.6%

Overall trend
Medical + Rx

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7.1%

Specialty
Medical + Rx

We continued to enhance existing programs and strategies and developed new ones designed to provide our members with access
to personalized pharmacy care and help keep spend down for our members and clients. Those efforts led to a low, single-digit trend; savings on the specialty and nonspecialty sides; reduced out-of-pocket expenses for our members; and greater savings and value for those members and clients in our high-performing pharmacy networks.

At IngenioRx, 2021 was a year of continued growth, change, and accomplishments.

Despite those impacts, IngenioRx was able to keep trend and spend down through our various mitigation strategies, along with our integrated medical and pharmacy offerings and capabilities.

In this report, we look behind the numbers to see the complete story for 2021 — with an unwavering focus on the future.

Three key factors drove 2021 drug trend:

• Utilization

• Inflation

• New drugs on the market

How did our approach to total health lead to savings in 2021? Our integrated approach across medical and pharmacy benefits drove down spend and improved overall outcomes.

 
Sydney Health is offered through an arrangement with CareMarket, Inc., a separate company offering mobile application services on behalf of IngenioRx ©2021-2022
©2021-2022 IngenioRx. All Rights Reserved. The IngenioRx name and IngenioRx logo are registered trademarks. Services provided by IngenioRx, Inc. In TX, services provided by Ingenio, Inc. No portion of this publication may be reproduced in any format, print, electronic, or otherwise, without the express written permission of IngenioRx.
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