Pharmaceutical Strategies Group (“PSG”), an EPIC company, today released its 2026 Artemetrx® State of Specialty Spend and Trend Report, sponsored by CenterWell Pharmacy®, highlighting continued growth in specialty drug spend, claim utilization as the primary driver of trend, and the market shifting in response to biosimilars. Now in its tenth year, PSG’s annual research analyzes real-world pharmacy and medical claims data to track trends in specialty drug spend and utilization.
“For a decade, this report has helped payers navigate the specialty drug landscape and prepare for what’s next,” said Mike Lonergan, President at PSG. “By leveraging real-world pharmacy and medical claims data, we provide actionable insights that help organizations stay ahead of fast-moving developments across the specialty drug market.”
Specialty Drug Spend and Trend Remain High
PSG’s report found that specialty drug trend was 10.8% on a gross basis and 12.5% net of rebates in 2025, continuing a multi-year run of low double-digit growth. Gross specialty drug costs increased to $1,548 PMPY, while net costs reached $1,251 PMPY. Looking ahead, PSG projects that gross PMPY specialty costs will jump by another 32% by 2028.
Additionally, post-rebate trend exceeded pre-rebate trend in 2025, reflecting the shrinking role of rebates as an offset to growing utilization, expanded indications, and high cost trend for some specialty medications and reinforcing specialty drug spend as a persistent cost-management challenge for payers.
“Continued growth in specialty drug spend is ongoing burden for payers,” said Morgan Lee, Vice President of Research and Marketing at PSG. “As spend continues to climb, understanding the relative roles of utilization and specialty drug costs in driving specialty drug trend is critical to developing effective management strategies and making informed decisions.”
Utilization Becomes Dominant Driver of Specialty Drug Trend
Claim utilization emerged as the dominant driver of specialty drug trend in 2025, accounting for 10.6 of the report’s 10.8% trend. Cost per claim contributed just 0.1 and may in the future become a downward influence on specialty drug trend as utilization continues to increase.
Biosimilar adoption has likely played a major role in reducing the role of cost per claim in specialty drug trend, while new drug approvals and expanded indications for existing drugs have fueled increased specialty drug utilization.
The share of members using at least one specialty drug also rose from 4.4% in 2023 to 5.5% in 2025, while claims per utilizer held steady at around five per year. These findings suggest trend is now being driven by more patients using specialty therapies rather than existing patients using more specialty drugs.
Rapid Biosimilar Adoption Changes the Specialty Drug Market
Overall biosimilar market share increased from 22.6% in 2023 to 56.3% in 2025, with Humira biosimilars playing a major role. Humira biosimilars climbed from 0.3% market share in 2023 to 82.4% market share in 2025, while Stelara biosimilars reached 18% market share in their first year on the market.
Major Shifts in Top Specialty Drugs by Spend Rankings
Inflammatory disorder remained the top specialty drug category by spend. Drugs in this category accounted for eight of the top 10 drugs by spend in 2025, even as Humira fell from number one to outside of the top 10 and Stelara experienced a 29% decline in utilization.
Meanwhile, Skyrizi, Rinvoq, Dupixent, and Tremfya posted upward utilization trends of 31%, 27%, 20%, and 16%, respectively. Expanded indications, direct-to-consumer advertising, and shifting utilization following the introduction of Humira and Stelara biosimilars likely contributed to this surge.
“As innovation accelerates and chronic conditions continue to drive the majority of healthcare spend, organizations must evolve their strategies to meet the increasing complexity of specialty care. This report offers timely insights that can help inform those strategies,” said Bethanie Stein, Pharm.D., President of Pharmacy at Humana, including CenterWell Pharmacy®. “At CenterWell, we are using these insights to continue advancing how we deliver integrated, patient-centered care and how we partner with our clients to improve outcomes for patients and the broader healthcare system.”
The full report is available here: https://www.psgconsults.com/industry-report/2026-artemetrx-state-of-specialty-spend-and-trend-report/.
The 2026 Artemetrx® State of Specialty Spend and Trend Report is based on PSG’s Artemetrx book of business data that includes medical and pharmacy claims. In 2025, PSG analyzed 204 million medical claims and 48 million pharmacy claims. Additional PSG research and prior reports can be found here.
About Pharmaceutical Strategies Group (PSG)
Pharmaceutical Strategies Group (PSG) is an independent pharmacy benefits consultant, relentlessly advocating for healthcare payers as they navigate complex and ever-changing drug cost management challenges. As a strategic partner, PSG empowers clients by providing industry-leading intelligence and technologies to improve clinical outcomes and realize billions of dollars in drug cost savings for clients every year.
About Artemetrx®
Artemetrx is a proprietary SaaS platform developed by Pharmaceutical Strategies Group. As a revolutionary technology solution integrating pharmacy and medical claims data for specialty drug cost management, Artemetrx provides market-leading specialty drug insights to payers. It delivers unparalleled intelligence and line-of-sight into serious challenges perpetuating out-of-control drug costs and compromised patient outcomes. PSG’s innovative drug management solutions, including Artemetrx, deliver actionable insights with exceptional financial and clinical value. PSG functions as a strategic partner through industry-leading intelligence and technologies to realize billions of dollars in drug cost savings for clients every year. https://www.psgconsults.com/solutions/data-analytics
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