CMS Drug Dashboards - Make Your Revenue Smarter

CMS Drug Dashboards

On , in Documents, by AQ-IQ LLC

Today, the Centers for Medicare & Medicaid Services (CMS) released a redesigned version of the Drug Spending Dashboards. For the first time, the dashboards include year-over-year information on drug pricing and highlight which manufactures have been increasing their prices.

The dashboards are interactive online tools that allow patients, clinicians, researchers, and the public to understand trends in drug spending. Data is reported for both Medicare and Medicaid. The new version of the dashboard reports the percentage change in spending on drugs per dosage unit and includes an expanded list of drugs.

Some of the most commonly used drugs across Medicare Part B, Medicare Part D, and Medicaid saw double-digit annual increases over the last few years. A few examples are highlighted in the tables below. Taking the 15 drugs with the highest total spending in each program, the drugs listed in the tables saw significant annual increases in spending per dosage unit from 2012 to 2016. Drugs were included if they experienced annual increases of at least 5 percent in Part B and at least 10 percent in Part D and Medicaid.

In 2012, Medicare spent 17 percent of its total budget, or $109 billion, on prescription drugs. Four years later in 2016, spending had increased to 23 percent, or $174 billion. In 2016, the drugs listed below accounted for $39 billion in total spending by Medicare and Medicaid.

Medicare Part B
Brand Name Generic Name Annual Growth Rate (2012-2016) Average Monthly Spending Per Beneficiary in 2016 Manufacturers
1 Orencia* Abatacept* 17.2%
($22 to $41)
$2,136 BMS Primarycare
2 Neulasta Pegfilgrastim 8.5%
($2,788 to $3,869)
$1,195 Amgen
3 Xolair Omalizumab 8.0%
($22 to $30)
$1,821 Genentech, Inc.
4 Vaccine Influenza Injection Muscle (Fluzone High-Dose)** 6.9%
($30 to $39)
N/A
5 Sandostatin Lar* Octreotide Acetate, mi-Spheres* 6.8%
($123 to $160)
$3,202 Novartis
6 Prevnar 13 Pneumococcal 13-Valent Vaccine 6.1%
($132 to $167)
N/A Wyeth Pharm
7 Remicade Infliximab 6.0%
($63 to $80)
$1,910 Janssen Biotech
8 Rituxan Rituximab 5.6%
($615 to $765)
$1,985 Genentech, Inc.

*Indicates multiple brand and/or generic names for a specific HCPCS code.
**Indicates brand/generic names unavailable. Name reflects the HCPCS short description.

Medicare Part D
Brand Name Generic Name Annual Growth Rate (2012-2016) Average Monthly Spending Per Beneficiary in 2016 Manufacturers
1 Renvela Sevelamer Carbonate 21.6%
($3 to $6)
$630 Genzyme
2 Lantus Insulin Glargine, Hum.Rec.Anlog 18.6%
($13 to $25)
$209 Sanofi-Aventis
3 Zetia Ezetimibe 18.3%
($5 to $9)
$181 Merck Sharp & D
4 Enbrel Etanercept 18.2%
($498 to $972)
$2,741 Amgen
5 Humira Pen Adalimumab 18.0%
($1,019 to $1,976)
$2,835 Abbvie US LLC
6 Lyrica Pregabalin 17.4%
($3 to $6)
$205 Pfizer US Pharm
7 Lantus Solostar Insulin Glargine, Hum.Rec.Anlog 14.2%
($14 to $25)
$196 Sanofi-Aventis
8 Crestor Rosuvastatin Calcium 13.2%
($5 to $8)
$124 Astrazeneca
9 Januvia Sitagliptin Phosphate 12.7%
($7 to $12)
$235 Merck Sharp & D
10 Xarelto Rivaroxaban 10.6%
($8 to $12)
$202 Janssen Pharm.
11 Eliquis Apixaban 10.4%
($4 to $6)
$194 BMS Primarycare

 

Medicaid
Brand Name Generic Name Annual Growth Rate (2012-2016) Manufacturers
1 Lantus Insulin Glargine, Hum.Rec.Anlog 18.7%
($13 to $25)
Sanofi-Aventis
2 Latuda Lurasidone HCl 18.6%
($17 to $33)
Sunovion Pharma
3 Lyrica Pregabalin 17.9%
($3 to $6)
Pfizer US Pharm
4 Enbrel Etanercept 17.6%
($487 to $933)
Amgen
5 Humira Pen Adalimumab 17.5%
($1,007 to $1,919)
Abbvie US LLC
6 Lantus Solostar Insulin Glargine, Hum.Rec.Anlog 14.3%
($15 to $25)
Sanofi-Aventis
7 Abilify Aripiprazole 11.4%
($21 to $32)
Otsuka America
8 Vyvanse Lisdexamfetamine Dimesylate 11.0%
($5 to $8)
Shire US Inc.

Also, as part of CMS’s commitment to transparency and data release, CMS today is updating the Part D Prescriber Public Use File (PUF) with data for 2016. This file includes summarized information on the more than one million distinct health care providers who prescribed drugs under the Part D program in 2016. This information enables a range of analyses to be performed on prescribing trends in Part D. The Part D Prescriber PUF is available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Part-D-Prescriber.html.

In all of CMS’s efforts, CMS protects the privacy and security of healthcare data. None of today’s releases include any patient-identifiable data. The dashboards and a downloadable, machine-readable version of the data presented in the dashboards can be accessed at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Information-on-Prescription-Drugs/index.html.

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