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Between 2010 and 2017, Americans nearly doubled their spending on pricey specialty medicines that they purchased at pharmacies or by mail. And this was after accounting for rebates paid by drug makers to health plans, according to a new analysis in Health Affairs.

Specifically, specialty drugs accounted for 38% of retail and mail-order prescription spending in 2017, compared to 20% in 2010. Drilling down, spending tripled for Medicare Part D beneficiaries and more than doubled for people who are covered by private insurance, although Medicaid spending rose at a slower pace — again, after allowing for rebates. And this growth occurred even though specialty drugs comprised a very small portion of retail prescriptions that were filled during this period of time.

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