Hepatitis c, diabetes and oncology are the primary drivers of the spending growth. Prescription growth is 1. 2 for the year. That is a substantial reduction from last year. The primary effect is the rescheduling of hydrocodone to more restrictive schedule which cut that market by 30 . And also you have more chronic care prescriptions are 90day prescriptions. 75 is on specialists. You cant look at that market here or everywhere around the World Without talking specialty. And next year we expect crestor to go off. So these are whats driving spending growth. You can see hepatitis at the top followed by diabetes, oncology, autoimmune, multiple sclerosis, hiv, respiratory, nervous system, and so forth. Almost all of the big five are in the specialty area. And if you look closely at the slide, and i assume youll get copies of this later, what the significant impacts are in each of these things and we break it down by new brands, whats going on with protected brands, with generics and patents
Arrangement, and are you guaranteeing what is the price of the drug when are you saying you are only going to get paid x if you reach a cure level or certain level of adherence. Theres some interference there, and its used as an excuse for those types of arrangement or getting out of those arrangements by pharmaceutical companies. The other is the fda approves the drug if it works. And they dont necessarily approve it saying whether it works better than things that have previously been approved or whether it doesnt work better than thing previously approved. And that can create some friction when it comes to dealing with providers who seem to want to gravitate toward the newest and the latest, even if it really doesnt turn out to work any better than some of the alternatives that have come down the pike before. So whats the solution there . More as we heard on the earlier panel, more effectiveness, information and data . I think the comparative effectiveness would really help. Then you