Medicare Part D payments for neurologist-prescribed drugs.
Ontology highlight
ABSTRACT:
SUBMITTER: De Lott LB
PROVIDER: S-EPMC4836880 | biostudies-other | 2016 Apr
REPOSITORIES: biostudies-other
Publications
Medicare Part D payments for neurologist-prescribed drugs.
De Lott Lindsey B LB De Lott Lindsey B LB Burke James F JF Kerber Kevin A KA Skolarus Lesli E LE Callaghan Brian C BC
Neurology 20160323 16
<h4>Objective</h4>To describe neurologists' Medicare Part D prescribing patterns and the potential effect of generic substitutions and price negotiation, which is currently prohibited.<h4>Methods</h4>The 2013 Medicare Part D Prescriber Public Use and Summary files were used. Payments for medications were aggregated by provider and drug (brand or generic). Payment, proportion of generic claims or day's supply, and median payment per monthly supply of medication were calculated by physician specia ...[more]
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Project description:ImportanceRising pharmaceutical costs in the United States are an increasing source of financial burden for payers and patients. Although topical steroids are among the most commonly prescribed medications in dermatology, there are limited data on steroid-related spending and utilization.ObjectiveTo characterize Medicare and patient out-of-pocket costs for topical steroids, and to model potential savings that could result from substitution of the cheapest topical steroid from the corresponding potency class.Design, setting, and participantsThis study was a retrospective cost analysis of the Medicare Part D Prescriber Public Use File, which details annual drug utilization and spending on both generic and branded drugs from 2011 to 2015 by Medicare Part D participants who filled prescriptions for topical steroids.Main outcomes and measuresTotal and potential Medicare and out-of-pocket patient spending. Costs were adjusted for inflation and reported in 2015 dollars.ResultsMedicare Part D expenditures on topical steroids between 2011 and 2015 were $2.3 billion. Patients' out-of-pocket spending for topical steroids over the same period was $333.7 million. The total annual spending increased from $237.6 million to $775.9 million, an increase of 226.5%. Patients' annual out-of-pocket spending increased from $41.4 million to $101.8 million, an increase of 145.9%. The total number of prescriptions were 7.7 million in 2011 and 10.6 million in 2015, an increase of 37.0%. Generic medication costs accounted for 97.8% of the total spending during this time period. The potential health care savings and out-of-pocket patient savings from substitution of the cheapest topical steroid within the corresponding potency class were $944.8 million and $66.6 million, respectively.Conclusions and relevanceMost topical steroids prescribed were generic drugs. There has been a sharp increase in Medicare and out-of-pocket spending on topical steroids that is driven by higher costs for generics. Use of clinical decision support tools to enable substitution of the most affordable generic topical steroid from the corresponding potency class may reduce drug expenditures.
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