And the answer is…. 82 percent. At least according to the latest annual report on prescription drug spending released by Express Scripts, the pharmacy benefits manager. Of course, such a finding is not surprising, given that the cost of generics fell by 10.2 percent compared with a rise in brand-name meds by 9.7 percent.

Rising drug prices have caused a stir on several fronts in recent weeks, in fact. The manufacturer of an injectable drug to prevent premature births, KV Pharmaceuticals, last week slashed the price after coming under pressure (see this) and an order of Catholic nuns successfully placed shareholder proposals over rising drug prices (look here).

Nonetheless, the overall growth in spending on prescription drugs - including specialty medications, such as biologics, was cut nearly in half last year to 3.6 percent from 6.4 percent in 2009. For so-called traditional drugs, spending fell 1.4 percent from 4.8 percent in 2009, while specialty spending rose 19.6 percent, which was about the same rate of increase registered in 2009.

However, Express Scripts noted that gains from greater use of lower-cost meds, such as generics, were offset by price increases. A pharmaceutical industry analyst at Barclays Capital recently reported that prices for 130 best-selling brand-name drugs rose 6.9 last year, which was the biggest increase in a decade (here is the complete Express Scripts report).

Some other findings: cholesterol and diabetes meds tied for the largest Per Member Per Year (PMPY)
cost, with each representing 9.1 percent of the total spending on traditional meds and nearly 8 percent oveall. Spending on drugs for attention deficit disorders rose 16.9, mostly because of greater use. And spending on ulcer meds fell 13.7 percent thanks to generics and over-the-counter options.

The top three specialty classes - inflammatory afflications, multiple sclerosis and cancer - represent 68 percent of total specialty spending. And the average copayment for specialty med rose t0 $54.19, a jump of 13.5 percent.

By the way, 58 percent of patients who are not taking their meds believe they actually are doing so as prescribed. This contributes to $56 billion in wasted health care costs, according to Express Scripts, whose survey canvassed 2,099 people. because this results in unnecessary hospital admissions, emergency room vists, additional physician visits, extra lab tests, and added therapy.

Overall, the PBM argues there is $403 billion in waste, including $88.3 billion if consumers would stop buying their meds from retail pharmacies and switch to home delivery. Of course, as a PBM, Express Scripts benefits from this argument. Someone pass the salt (as in ‘grain of’).