Federal health officials unveiled an online tool Monday that will allow the public and policymakers to explore the financial burden that scores of high-
expense drugs place on the Medicare program and the nation's seniors.
It shows that the hepatitis C drug Solvadi, a cure that hit the market last year with a $1,000-per-pill price tag, rocketed to become the drug for which Medicare expenditures were highest in 2014. About 33,000 Medicare beneficiaries took the drug for total spending of $3.1 billion when combining the government’s and patients’ portions.
Nexium, prescribed to treat acid reflux for 1.4 million beneficiaries, had the second-highest expenditure at nearly $2.6 billion. Crestor, a medicine to control cholesterol levels, and Abilify, prescribed for psychiatric and mood disorders, ranked third and fourth, respectively, at more than $2 billion each.
Health and Human Services officials created the dashboard at a time when surveys suggest that making medicines more affordable is the public’s leading health policy concern. U.S. drug spending increased 12 percent last year, far more than other health-care costs.
On Monday, officials portrayed their new analysis as a sequel to a forum on drug prices that the department convened last month to demonstrate the Obama administration’s attention to escalating drug expenditures. The day-long forum assembled researchers, consumer advocates, pharmaceutical company executives and insurance industry representatives.
Like the forum, the dashboard was not accompanied by any ideas for changing federal policy involving drug prices.
The White House trumpeted the new dashboard as part of a broader administrative effort to improve transparency in health-care spending and said that a similar online instrument for Medicaid prescription-drug costs would follow next year.
“While this new tool doesn’t answer all of the questions surrounding prescription drug spending, it is a jumping off point for further discussions regarding these important issues,” Jeanne Lambrew, deputy assistant to the president for health policy, wrote in a blog post.
In a briefing for journalists, Niall Brennan, chief data officer for the Centers for Medicare and Medicaid Services, sidestepped the question of whether a change long sought by the Obama administration — giving the government power to negotiate prices in Medicare drug benefits — would change the trends in spending.
For the dashboard, CMS culled information about 80 drugs from the expenditure data in Medicare, the federal insurance program that covers about 50 million people 65 and older. Half of the drugs chosen for the list were from the part of Medicare that covers outpatient treatment, and half were from “Part D,” the prescription-drug benefit added to the program nearly a decade ago.
Drugs were chosen for the list if they were among the top 15 in overall spending for either of those two parts of the program, had a high level of per-patient spending or had the greatest price increases. The data are for 2014 but compare trends in use and prices for the previous few years.
In total, those drugs account for about $55 billion in Medicare spending last year — about two-fifths of the $140 billion that Medicare spent on pharmaceuticals.
The data do not include patient rebates that some drug manufacters offer, effectively lowering prices. Brennan said that internal analyses found that the drugs listed would not be much different if rebates had been taken into account.
On Wednesday, a spokesman for PhRMA, the pharmaceutical industry’s main trade group, contended that the data that health officials selected for the dashboard present “a misleading and incomplete picture of actual Medicare spending on prescription medicines by focusing on a small subset of medicines.”
Robert Zirkelbach said the kind of rebates excluded from the data have been increasing and can reduce some prices by 20 percent to 30 percent. He also said the dashboard does not factor in the role that medicine can play in keeping older patients in better health and thus avoiding Medicare expenditures elsewhere in the health-care system.
