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CMS expands interactive drug pricing tool to include Medicaid drug costs, rebate information
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CMS has updated an interactive tool that tracks drug prices for Medicare beneficiaries to include information on drugs purchased for Medicaid beneficiaries as well as rebates provided by drug manufacturers, the agency announced on its blog.
“We know that millions of Americans have come to rely on these prescription drugs to manage their chronic conditions or to treat serious illnesses,” Andy Slavitt, CMS acting administrator, Niall Brennan, CMS chief data officer, and Tim Gronniger, CMS deputy chief of staff, wrote in a posting for The CMS Blog on Nov. 14. “Maintaining access to those medications is the reason we believe informed dialogue on how to manage costs and cost increases are so important.”
The interactive tool, launched last year, allows the public to view drugs in Medicare Part B and D with high spending on a per user basis, high spending for the program overall, and high unit cost increases in recent years. Individual entries also contain graphs on trends for specific drugs during the past 5 years.
The dashboard provides trend analyses as well as additional detailed information on each drug, such as drug spending, number of prescription fills, brand and generic name, uses and the name of the manufacturer.
For Medicare, the dashboard presents 2015 data from the top 15 drugs in total program spending, 15 drugs with both very high per-user spending and significant program spending, and 10 drugs with very high unit costs increases. Included drugs are provided through both the Medicare Prescription Drug Program under Part D and the Medicare fee-for-service program under Part B.
Among the key findings:
The top two Medicare Part D drugs — the combination drug ledipasvir/sofosbuvir (Harvoni, Gilead) to treat hepatitis C and insulin glargine (Lantus, Sanofi) — were also included in the top five Medicaid drugs for total spending. Each was associated with more than $1 billion in Medicaid spending.
Of the 20 drugs with the highest per-unit cost increases in Medicaid, nine were generic drugs, according to the authors. Those products had increases in price ranging from 140% to nearly 500% from 2014 to 2015.
For Medicare beneficiaries, metformin hydrochloride (Glumetza, Salix) had an average unit cost increase of 381% in Part D from 2014 to 2015. Three other drugs had increases of more than 200%.
The DPP-IV inhibitor sitagliptin (Januvia, Merck) accounted for more than $2 billion in total spending, with total annual spending per user at $2,572 and a 14% average unit cost increase from 2014 to 2015.
The statin rosuvastatin (Crestor, AstraZeneca) accounted for nearly $3 billion in total spending, with total annual spending per user at $1,664 and a 14% average unit cost increase from 2014 to 2015.
The data do not include rebate information that Medicare may receive from pharmaceutical manufacturers, but the tool includes an aggregated summary of Medicare Part D manufacturer rebate information for several broad categories of brand name drugs in 2014.
“As administrators for the Medicare and Medicaid program, our most important goal is to make sure that beneficiaries have access to high-value, innovative medicines that improve their lives,” the authors wrote. “But because costs necessarily get passed on to beneficiaries and taxpayers through higher premiums, coinsurance and taxes, we also have a responsibility to ensure that access to those medicines remains affordable. We hope by providing a better view into our spending on prescription drugs, this understanding can help policymakers, manufacturers, purchasers and consumers to work together to better the health of all Americans.” – by Regina Schaffer
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