Express Scripts' annual drug trend report highlights impact of key follow-on launches, and its own management solutions programs, in limiting the growth in overall drug spending for commercial plans to 1.5%; forecast calls for double-digit growth in inflammatory category to continue at least the next three years until biosimilar savings kick in.

And for diabetes, Jardiance is out and Invokana is in; CVS formulary update includes far fewer exclusions than previous years and reinstates coverage for several drugs, signaling more muted approach to management.

Findings could provide a basis for future policy interventions, the department says. Speeding generics and biosimilars would seem a natural outshoot of the conclusions, but the report does not contain any recommendations.