Updated CMS drug dashboards show prescription price hikes sustained by Medicaid, Medicare

Drugs and money
Rising prescription drug prices have led Medicaid prescription drug spending to rise by nearly 15% between 2013 and 2017, CMS officials said on Thursday. (Getty/LIgorko)

One of the drugs paid for by Medicaid plans with the largest price growth in five years is a $5,000-per-unit medication for sore throats.

Average spending per dose of Cepacol Sore Throat grew nearly 1,000% from $493 in 2016 to $5,000 in 2017, according to updated Centers for Medicare & Medicaid Services drug dashboards released on Thursday.

At a total Medicaid spending of about $34,000, the drug manufactured by Reckitt Benckiser was but a tiny blip in the overall spending by the federal healthcare program last year. 


2019 Drug Pricing and Reimbursement Stakeholder Summit

Given federal and state pricing requirements arising, press releases from industry leading pharma companies, and the new Drug Transparency Act, it is important to stay ahead of news headlines and anticipated requirements in order to hit company profit targets, maintain value to patients and promote strong, multi-beneficial relationships with manufacturers, providers, payers, and all other stakeholders within the pricing landscape. This conference will provide a platform to encourage a dialogue among such stakeholders in the pricing and reimbursement space so that they can receive a current state of the union regarding regulatory changes while providing actionable insights in anticipation of the future.

But it's an example of the information contained within the dashboards that Trump administration officials said show what has led Medicaid prescription drug spending to rise by nearly 15% between 2013 and 2017. Average spending per dosage unit for prescription drugs paid under Medicare Parts B and D rose 10.6% and 10%, respectively. 

I've reached out to CMS and Reckitt for comment and will update you when I hear back

In 2017, total gross spending on prescription drugs was $154.9 billion in Medicare Part D, $30.4 billion in Part B, and $67.6 billion in Medicaid. The updated drug dashboards added information on "which manufacturers are responsible for price increases," officials said. 

"These data shed light on the kind of abusive behaviors we’re addressing with the President’s Budget and his drug pricing blueprint," said Health and Human Services Secretary Alex Azar in a statement to the Senate Finance Committee.

The dashboards include pricing and spending data for thousands of additional drugs across Medicare Parts B and D and Medicaid, officials said. 

The dashboards focus on average spending per dosage unit for prescription drugs paid under Medicare Parts B and D and Medicaid, and track the change in average spending per dosage unit over time. It's presented in an interactive web-based tool to allow researchers and consumers to sort the data to identify trends.

For instance, in Medicaid spending, Daptomycin, an antibiotic used for severe bacterial infections, increased in price more than 13,000% between 2013 and 2017.

It dipped 22% from an average price per dose of $171.70 in 2016 to an average price per dose of $132.73 in 2017, the same year Fresenius Kabi entered the market with a generic version of Merck's Cubicin.  The antibiotic is also manufactured by Teva Parenteral and cost Medicaid a total of $32.1 million in 2017.

A spokesman for Fresenius said he could not comment on pricing and cost to the system prior to the company's entry to the market in 2016. Teva did not respond to a request for comment.

RELATED: Trump's drug pricing plan pushes for increased price transparency, greater use of generics 

The top three drugs that accounted for the most overall Medicaid spending were the Humira Pen, which is used for treating different forms of arthritis, as well as the hepatitis C drug Humira and the antipsychotic drug Latuda. They represented $1.2 billion, $1.2 billion and $1 billion in spending, respectively.

Among the data on drug spending in the dashboards: 

  • While the percentage growth might be high, the overall unit prices might not be. For instance, the biggest price growth over the five-year period on Medicare Part D was a drug called Virt-Nate, a multivitamin and iron product used to treat or prevent vitamin deficiency due to poor diet, certain illnesses, or during pregnancy. Its price grew by more than 4,000%, which put it at an average unit cost per dosage unit of 48 cents.

  • Some of the drugs are only used for a small number of patients. The drug with the biggest price growth under Medicare Part B was Miacalcin, a medication used for postmenopausal osteoporosis that rose in cost by 119% between 2013 and 2017. Its price rose 59% from $12.14 for an average spending per unit dosage in 2016 to $19.24 in 2017. Used for 16 beneficiaries, it cost Medicare Part B a total of about $2 million in 2017.

"The dashboards complement other CMS efforts to increase transparency on drug prices, including recent proposals to require prescription drug manufacturers to include list prices in television advertisements and proposals to implement legislation signed by President Trump to end the practice of pharmacy gag clauses," said CMS Administrator Seema Verma in a statement. "Pharmacy gag clauses can prevent pharmacists from telling patients how to access prescription drugs at the lowest cost."

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