Projecting future drug expenditures--2007 (original) (raw)
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Israel Journal of Health Policy Research, 2016
Background: Modern drug therapy accounts for a major share of health expenditure and challenges public provider resources. The objective of our study was to compare drug expenditure trends for ten major drug classes over 16 years at Maccabi Healthcare Services (MHS), the 2 nd largest healthcare organization in Israel. Methods: A retrospective analysis of drug expenditure per HMO beneficiary between the years 1998-2014. Trends in annual mean drug expenditures per MHS member were compared among 10 major drug classes. Results: Average annual drug expenditure per beneficiary increased during the study period from 429.56 to 474.32 in 2014 (10.4 %). Ten drug classes accounted for 58.0 % and 77.8 % of total drug cost in 1998 and 2014, respectively. The overall distribution of drug expenditure among drug classes differed significantly between 1998 and 2014 (p < 0.001), mainly due to the increase in expenditure for cancer drugs, from 6.8 % of total drug cost to 30.3 %. In contrast, expenditures for cardiovascular drugs decreased during the same period from 16.0 to 2.7 %. Moreover, the median annual increase in net drug costs per HMO member during 1998-2014 was largest for cancer drugs (NIS 6.18/year; IQR, 1.70-9.92/year), about twofold that of immunosuppressants, the second fastest growing drug class (NIS 2.81; IQR, 0.58-7.43/year). Conclusions: The continuous rise in anti-cancer drug expenditure puts a substantial burden on the medication budgets of public health organizations. Coordinated measures involving policy makers, physicians, and pharmaceutical companies will be required for efficient cost containment.
Recent Trends in Prescription Drug Use and Expenditures by Medicaid Enrollees
2012
Background: As prescription drug expenditures consume an increasingly larger portion of Medicaid budgets, states are anxious to control drug costs without endangering enrollees' health. Objective: We use the 2001/02 and 2007/08 Medical Expenditure Panel Survey to analyze recent trends in Medicaid prescription drug expenditures by therapeutic classes and subclasses. Identifying the fastest growing categories of drugs, where drugs are grouped into clinically relevant classes and subclasses, can help inform policymakers' efforts to contain costs. Findings: We found that total drug expenditures for Medicaid enrollees increased by 47.4 percent from 2001/02 to 2007/08. In 2007/08, the top five therapeutic classes ranked by total annual expenditures were psychotherapeutic drugs, cardiovascular drugs, CNS agents, respiratory agents and antidiabetic agents, while the top five therapeutic subclasses were antipsychotics, anticonvulsants, antihyperlipidemics, asthma controller medications and antidepressants. More than a third (35.8 percent) of the estimated 42.1billioninMedicaiddrugexpenditureswasattributabletothesefivesubclasses,whichhadexpenditurestotaling42.1 billion in Medicaid drug expenditures was attributable to these five subclasses, which had expenditures totaling 42.1billioninMedicaiddrugexpenditureswasattributabletothesefivesubclasses,whichhadexpenditurestotaling15.1 billion in 2007/08. The percentage of prescriptions dispensed as generics increased from 45.4 to 60.0 percent during the period of our study. The fastest growing subclasses − including antipsychotics, CNS stimulants, and angiotensin inhibitors-had low rates of generic penetration and rapid increases in the population with use. In contrast, subclasses such as antihistamines and metformins-had declining total expenditures as generic penetration increased and expenditures per user fell.
Annals of internal medicine, 2016
This American College of Physicians position paper, initiated and written by its Health and Public Policy Committee and approved by the Board of Regents on 16 February 2016, reports policy recommendations from the American College of Physicians to address the escalating costs of prescription drugs in the United States. Prescription drugs play an important part in treating and preventing disease. However, the United States often pays more for some prescription drugs than other developed countries, and the high price and increasing costs associated with prescription medication is a major concern for patients, physicians, and payers. Pharmaceutical companies have considerable flexibility in how they price drugs, and the costs that payers and patients see are dependent on how payers are able to negotiate discounts or rebates. Beyond setting list prices are issues of regulatory approval, patents and intellectual property, assessment of value and cost-effectiveness, and health plan drug b...
The Benefits and Costs of Newer Drugs: Evidence from the 1996 Medical Expenditure Panel Survey
2001
The nation's spending for prescription drugs has grown dramatically in recent years. Previous studies have shown that the replacement of older drugs by newer, more expensive, drugs is the single most important reason for this increase, but they did not measure how much of the difference between new and old drug prices reflects changes in quality as better, newer drugs replace older, less effective medications. In this paper we analyze data from the 1996 Medical Expenditure Panel Survey (MEPS) to provide evidence about the effect of drug age on mortality, morbidity, and total medical expenditure, controlling for sex, age, education, race, income, insurance status, who paid for the drug, the condition for which the drug was prescribed, how long the person has had the condition, and the number of medical conditions reported by the person. The results provide strong support for the hypothesis that the replacement of older by newer drugs results in reductions in mortality, morbidity, and total medical expenditure. People consuming new drugs were significantly less likely to experience work-loss days and to die by the end of the survey than people consuming older drugs. The estimates indicate that reductions in drug age tend to reduce all types of non-drug medical expenditure, although the reduction in inpatient expenditure is by far the largest. Reducing the age of the drug results in a substantial net reduction in the total cost of treating the condition. Allowing people to use only generic drugs would increase total treatment costs, not reduce them, and would lead to worse outcomes.