Medicare drug spending dashboard gives stakeholders insight into usage, costs

CMS’ new Medicare Drug Spending Dashboard provides stakeholders with spending information related to 80 prescription drugs in the Part B and Part D programs. The online dashboard is now available online and includes information about drugs that generated high program or consumer spending in 2014, or that underwent significant cost increases. In addition to increasing transparency in the Part B and D programs, CMS hopes that the data will spur discussion about the benefits of using these drugs and their effects on beneficiary costs.

Inclusion of drugs

CMS selected 40 drugs from the Part B program and 40 from the Part D program for inclusion in the dashboard, based on 2014 data. To qualify, drugs were required to rank among the top 15 prescription drugs in terms of respective program spending; be associated with individual user spending in excess of $10,000 and rank in the top 15 of overall program spending; or rank among the top 10 high unit cost increases. The data demonstrate the drugs’ significant impact on Medicare spending. For example, the 15 highest spending Part B drugs in 2014 accounted for roughly 2 percent of Part B drugs, but accounted for 53 percent of total Part B spending. The 15 highest spending Part D drugs accounted for less than 1 percent of all Part D drugs, but accounted for 24 percent of program spending.

Trends of note

The dashboard also reveals that the top five high program spending drugs in the Part D program were more expensive than those in the Part B program, with all five top Part D drugs having more than $2 billion in spending in 2014, compared to more than $1 billion in spending for the Part B drugs. In addition, the highest spending Part D drugs were brand drugs, while the highest spending Part B drugs were generics. The highest Part B user spending drug, ranibizumab, which is used to treat macular degeneration, was used by 141,606 beneficiaries in 2014, with average spending of $9,401 per user and total Part B spending of $1.3 billion. The highest Part D beneficiary spending drug, Humira®, which treats rheumatoid arthritis, was used by more than 50,000 beneficiaries, with average user spending of $24,000 and total Part D spending of $1.2 billion. The price of the Part D pain reliever Vimovo® increased by an average of more than 500 percent per unit from 2013 to 2014; in contrast, the injectable Part B Vitamin B-12 drug Cyanocobalamin, increased by 78 percent.

Feedback

CMS hopes that the dashboard will open a discussion regarding the value of these drugs and their effects on spending. While it notes that the dashboard does not include information about manufacturer rebates because CMS is prohibited from disclosing that information to the public, the agency believes that such information, along with other useful data, are available from other agencies, and hopes the creation of the dashboard will encourage those agencies to disclose useful data to the public. CMS has asked for feedback on the dashboard, in particular regarding the value of information it contains, gaps in clinical knowledge about listed products, and other types of useful information that it should include. Comments can be emailed to druglistinput@cms.hhs.gov.