scholarly journals Effects of Medicare Part D on drug affordability and use: Are seniors with prior high out-of-pocket drug spending affected more?

2010 ◽  
Vol 6 (2) ◽  
pp. 90-99 ◽  
Author(s):  
David A. Mott ◽  
Joshua M. Thorpe ◽  
Carolyn T. Thorpe ◽  
David H. Kreling ◽  
Abhijit S. Gadkari
Keyword(s):  
Medicare Part D ◽  
Medicare Part ◽  
Drug Spending ◽  
Part D ◽  
Drug Affordability

scholarly journals PNS110 CONSOLIDATED DRUG PURCHASING ACROSS FEDERAL AGENCIES: A SOLUTION TO IMPROVE DRUG AFFORDABILITY IN MEDICARE PART D

2019 ◽  
Vol 22 ◽  
pp. S303
Author(s):  
J. Levin ◽  
J. Ballreich ◽  
M.P. Socal ◽  
G. Bai ◽  
G. Anderson
Keyword(s):  
Medicare Part D ◽  
Federal Agencies ◽  
Medicare Part ◽  
Part D ◽  
Drug Affordability

Medicare Part D spending for the 10 costliest oral anticancer drugs.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 52-52
Author(s):  
Kaitlyn McBride ◽  
Sophie Snyder
Keyword(s):  
Prescription Drugs ◽  
Cost Effective ◽  
Medicare Part D ◽  
Medicare Part ◽  
Drug Spending ◽  
Part D ◽  
Annual Total ◽  
Wholesale Acquisition Cost

52 Background: Novel oral targeted drugs are being used more frequently to treat many cancers and have substantially improved clinical and survival outcomes. Due to the long treatment durations of many of these medications, which are given continuously until patient progression, per-patient lifetime costs can be high. This study aimed to identify the ten oral anticancer therapies with the highest annual Medicare Part D spending. Methods: Descriptive statistics were performed on data obtained from the CMS Medicare Part D Drug Spending Dashboard and IBM Micromedex RED BOOK, from 2018-2019. Medicare Part D dashboard includes total and average drug spending, and number of beneficiaries utilizing the drug. RED BOOK provides current and historical average wholesale pricing (AWP) data for all prescription drugs. The wholesale acquisition cost (WAC) was calculated from the AWP to evaluate trends in price. We identified the ten anticancer brand-name medications in 2019 with the highest annual Part D spending and reported changes in average spending and number of unique beneficiaries for each drug from 2018-2019. Results: In 2019, Revlimid had the highest annual total Part D spending at $4.6 billion, followed by Imbruvica with $2.4 billion; these drugs also had the greatest number of beneficiary utilizers. From 2018-2019, change in average spending per dosage unit was greatest for Zytiga (34%), however among all drugs, average spending per beneficiary in 2019 was lowest for this medication ($58,074). From 2018-2019, WAC and average spending per dosage unit increased for all of the top ten drugs, as well as the number of total beneficiaries utilizing each drug, except for Zytiga and Sprycel. Conclusions: Oral anticancer therapies provide high value for patients, including improved quality of life and survival. Annual costs for these drugs are high, however spending on inpatient hospital services remains a greater share of total Medicare spending in aggregate and on a per beneficiary basis. Emerging one-time curative treatments for cancer may prove most cost-effective in the long-term by eliminating the need for continuous medication use and hospital care, while improving patient outcomes.[Table: see text]

scholarly journals The Response of Drug Expenditure to Nonlinear Contract Design: Evidence from Medicare Part D *

2015 ◽  
Vol 130 (2) ◽  
pp. 841-899 ◽  
Author(s):  
Liran Einav ◽  
Amy Finkelstein ◽  
Paul Schrimpf
Keyword(s):  
Medicare Part D ◽  
Drug Expenditure ◽  
Medicare Part ◽  
Simple Extension ◽  
Drug Spending ◽  
Baseline Model ◽  
Part D ◽  
Insurance Contracts ◽  
Donut Hole ◽  
Using Data

Abstract We study the demand response to nonlinear price schedules using data on insurance contracts and prescription drug purchases in Medicare Part D. We exploit the kink in individuals’ budgets set created by the famous “donut hole,” where insurance becomes discontinuously much less generous on the margin, to provide descriptive evidence of the drug purchase response to a price increase. We then specify and estimate a simple dynamic model of drug use that allows us to quantify the spending response along the entire nonlinear budget set. We use the model for counterfactual analysis of the increase in spending from “filling” the donut hole, as will be required by 2020 under the Affordable Care Act. In our baseline model, which considers spending decisions within a single year, we estimate that filling the donut hole will increase annual drug spending by about $150, or about 8 percent. About one-quarter of this spending increase reflects anticipatory behavior, coming from beneficiaries whose spending prior to the policy change would leave them short of reaching the donut hole. We also present descriptive evidence of cross-year substitution of spending by individuals who reach the kink, which motivates a simple extension to our baseline model that allows—in a highly stylized way—for individuals to engage in such cross-year substitution. Our estimates from this extension suggest that a large share of the $150 drug spending increase could be attributed to cross-year substitution, and the net increase could be as little as $45 a year.

scholarly journals Sources of Regional Variation in Medicare Part D Drug Spending

2012 ◽  
Vol 366 (6) ◽  
pp. 530-538 ◽  
Author(s):  
Julie M. Donohue ◽  
Nancy E. Morden ◽  
Walid F. Gellad ◽  
Julie P. Bynum ◽  
Weiping Zhou ◽  
...  
Keyword(s):  
Regional Variation ◽  
Medicare Part D ◽  
Medicare Part ◽  
Drug Spending ◽  
Part D

scholarly journals The Effects Of The Coverage Gap On Drug Spending: A Closer Look At Medicare Part D

2009 ◽  
Vol 28 (Supplement 1) ◽  
pp. w317-w325 ◽  
Author(s):  
Yuting Zhang ◽  
Julie Marie Donohue ◽  
Joseph P. Newhouse ◽  
Judith R. Lave
Keyword(s):  
Medicare Part D ◽  
Medicare Part ◽  
Drug Spending ◽  
Part D ◽  
Coverage Gap

scholarly journals The Price Elasticity of Specialty Drug Use: Evidence from Cancer Patients in Medicare Part D

2017 ◽  
Vol 20 (2) ◽  
Author(s):  
Jeah Jung ◽  
Roger D. Feldman ◽  
Marshall McBean
Keyword(s):  
Drug Use ◽  
Price Elasticity ◽  
Cost Sharing ◽  
Medicare Part D ◽  
Medicare Part ◽  
Cancer Drug ◽  
Drug Spending ◽  
Cancer Drugs ◽  
Part D ◽  
Initial Price

Abstract Specialty drugs can bring substantial benefits to patients with debilitating conditions, such as cancer, but their costs are very high. Insurers/payers have increased patient cost-sharing for specialty drugs to manage specialty drug spending. We utilized Medicare Part D plan formulary data to create the initial price (cost-sharing in the initial coverage phase in Part D), and estimated the total demand (both on- and off-label uses) for specialty cancer drugs among elderly Medicare Part D enrollees with no low-income subsidies (non-LIS) as a function of the initial price. We corrected for potential endogeneity associated with plan choice by instrumenting the initial price of specialty cancer drugs with the initial prices of specialty drugs in unrelated classes. We report three findings. First, we found that elderly non-LIS beneficiaries with cancer were less likely to use a Part D specialty cancer drug when the initial price was high: the overall price elasticity of specialty cancer drug spending ranged between −0.72 and −0.75. Second, the price effect in Part D specialty cancer drug use was not significant among newly diagnosed patients. Finally, we found that use of Part B-covered cancer drugs was not responsive to the Part D specialty cancer drug price. As the demand for costly specialty drugs grows, it will be important to identify clinical circumstances where specialty drugs can be valuable and ensure access to high-value treatments.

Sign in / Sign up

Export Citation Format

Share Document