Annual 2019 Drug Trend Report from Express Scripts. Short overview report for healthcare leaders and managers interested in 2019 drug trends for cost and utilization. Costs went up 2.3% for commercial plans in 2019, driven by specialty brand drugs for inflammatory conditions. Medicare spending increased 1.2%; Medicare drug spending was led by specialty brand oncology drugs. Medicaid spending went up by 6.9%, with greatest spending on diabetes brand drugs. Lower unit costs of drugs for pain and inflammation, oncology, antidepressants and high cholesterol helped to reduce overall drug costs.