Medicare spent more than $103 billion on Part D prescriptions in 2013, according to a comprehensive data set released by the Centers for Medicare & Medicaid Services (CMS) yesterday.
Ten name-brand drugs alone account for nearly $19 billion in spending, CMS outlined in an accompanying fact sheet. Spending on four medications--heartburn drug Nexium, asthma treatment Advair, cholesterol drug Crestor and the antipsychotic Abilify--topped $2 billion each.
Meanwhile, the Associated Press reported that physicians prescribed the generic heartburn drug omeprazole 6.4 million times, more than four times as often as Nexium, for a total cost that was less than one-fourth the $2.5 billion Part D spent on Nexium.
"From a practical perspective there is no substantive advantage to giving someone Nexium over omeprazole," Michael Steinman, M.D., a geriatrician and professor at the University of California, San Francisco, told the AP. "The main difference between them is cost, marketing frankly."
More than 75 percent of Part D drugs prescribed in 2013 were generics, CMS noted. Increased prescribing of generic drugs has helped Medicare curtail spending growth, FierceHealthPayer previously reported, though costly hepatitis C treatments might soon erase those gains.
Physicians in family practice, internal medicine and psychiatry prescribed the largest variety of drugs, CMS said, while those in rheumatology, neurology and oncology filed the most expensive claims. The Wall Street Journal reported that two single cancer treatments--Celgene's Revlimid, for blood cancer, and Teva's multiple sclerosis drug Copaxone--accounted for 26 percent of Part D drug spending in 2013.
Acting CMS administrator Andy Slavitt said in a statement that the data release is part of the agency's larger effort to improve transparency. "Beneficiaries' personal information is not available; however, it's important for consumers, their providers, researchers, and other stakeholders to know how many prescription drugs are prescribed and how much they cost the healthcare system, so that they can better understand how the Medicare Part D program delivers care."
The $103 billion in spending does not include rebates paid by pharmaceutical companies. Overall, the government spend $69.7 billion on Part D in 2013, the Journal said. The Office of Inspector General recently criticized CMS for Part D rebates that were "substantially" lower than those obtained by Medicaid for the same drugs.
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