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Medicare, out-of-pocket payments for topical steroids sharply increase

There was a sharp increase in Medicare and out-of-pocket costs of prescribed topical steroids between 2011 and 2015, likely due to the rising costs of generic drugs, according to study results recently published in JAMA Dermatology.

Researchers conducted a retrospective cost analysis on patients who filled prescriptions for topical steroids. They used population-based claims data from the Medicare Part D Prescriber Public Use File, which provides prescription costs for approximately 70% of Medicare Part D participants.

Topical steroids in the Medicare Part D program between 2011 and 2015 cost $2.3 billion, with patients’ out-of-pocket spending totaling $333.7 million during the period. There was an increase of 226.5% in total annual spending, from $237.6 million to $775.9 million.

There was a 145.9% increase in patients’ annual out-of-pocket spending, from $41.4 million to $101.8 million.

The total number of prescriptions increased 37%, from 7.7 million in 2011 to 10.6 million in 2015, with generic medication costs accounting for 97.8% of total spending.

The researchers also calculated potential health care savings and out-of-pocket savings if all beneficiaries had received the cheapest generic topical steroids within their potency group, and identified potential health care savings of $944.8 million and total potential out-of-pocket saving of $66 million during the study period.

“The disproportionate increase in aggregate drug spending compared with claims suggests that the increase in spending is likely largely due to rising drug prices,” the researchers wrote. “Both patients and the health care system bear the financial burden of these higher costs.”

“It is imperative that health policies emerge that regulate pharmaceutical company practices and improve transparency surrounding drug costs,” the researchers concluded. “Until that time, interventions such as electronic medical record-based clinical support may allow clinicians to prescribe the most affordable topical steroids available on the market, ensuring efficacy while minimizing costs. Without these efforts, routine medications my become prohibitive in costs for our patients.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.