Healio
Healio
November 23, 2016
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Medicare drug spending cost per unit for adalimumab increased by 22%

From 2014 to 2015, the average Medicare cost per unit of adalimumab increased by 22%, according to an updated CMS medication tracking tool.

For its price tracking tool, the CMS added Medicaid drug spending and updated Medicare spending information from 2014 to 2015, according to a press release. The tool showed drug prices continued to increase.

For Medicare, rheumatoid arthritis (RA) biologics showed the following out-of-pocket prices:

  • abatacept, $4,368.86 spent out of pocket annually for each beneficiary (26% cost per unit increase from 2014);
  • rituximab, $4,367.26 (5% increase);
  • infliximab, $4,279.80 (6% increase);
  • certolizumab pegol, $3,580.70 (4% increase);
  • etanercept, $1,590 annually spent out of pocket for each beneficiary without low income subsidies or $34.12 for those with subsidies (19% increase); and
  • adalimumab, $1,588.22 for those without subsidies or $26.17 for those with subsidies (22% increase).

For Medicaid, RA biologics showed the following per-prescription prices:

  • adalimumab, $3,673.43 per prescription fill (22% prescription fill increase from 2014);
  • infliximab; $3,576.20 (7% increase); and
  • etanercept, $3,204.75 (18% increase).

“[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,” Andy Slavitt, acting administrator of CMS; Niall Brennan, chief data officer of CMS; and Tim Gronniger, deputy chief of staff of CMS, wrote in the release. “We hope by providing a better view into our spending on prescription drugs, this understanding can help policy makers, manufacturers, purchasers, and consumers to work together to better the health of all Americans.”

References:

https://blog.cms.gov/2016/11/14/updated-medicare-and-medicaid-drug-spending-dashboard/

www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/2015-Medicare-Drug-Spending/medicare-drug-spending-dashboard-2015-data.html

www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/2015-Medicaid-Drug-Spending/2015-Medicaid-Drug-Spending.html