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CMS Report: Nexium, Advair Led Medicare Drug Spending in 2013

New data offer first detailed look at Part D costs and services

Four brand-name drugs prescribed to older or disabled Americans covered by Medicare’s drug benefit accounted for almost one-tenth of the $103 billion in prescriptions filled under the plan in 2013, the Centers for Medicare & Medicaid Services (CMS) has reported.

The CMS said Nexium (esomeprazole, AstraZeneca) for acid reflux topped the list, with prescriptions totaling $2.5 billion, followed by $2.3 billion for the asthma drug Advair (fluticasone propionate/salmeterol, GlaxoSmithKline). Third place went to the cholesterol-lowering drug Crestor (rosuvastatin, AstraZeneca), with $2.2 billion worth of prescriptions, while the anti-psychotic agent Abilify (aripiprazole, Otsuka Corp.) came in fourth, with $2.1 billion.

The data cover prescriptions filled under the Medicare Part D prescription drug program. Approximately 68% of all Medicare beneficiaries (36 million people) are enrolled in the Part D program, according to the CMS. For the first time, the new dataset provides information on more than 1 million health care providers who collectively prescribed $103 billion in prescription drugs under the Part D program.

Although the top 10 most-prescribed drugs were all branded medications, the top 10 by number of claims were all generics.

The most-prescribed Medicare drug was lisinopril, a cardiovascular medication that treats hypertension, with 36.9 million prescriptions (at a total drug cost of $307 million). It was followed by the cholesterol-lowering drug simvastatin, with 36.7 million prescriptions (at a total cost of $434 million), and the thyroid drug levothyroxine sodium, with 35.2 million prescriptions (at a total cost of $396 million).

The five prescriber specialties with the highest total Part D drug costs were: internal medicine (at a total cost of $27 billion), family practice (at a total cost of $22 billion), nurse practitioner (at a total cost of $7 billion), neurology, and psychiatry (each at a total cost of $5 billion).

Psychiatry had the highest generic dispensing rate (81.9%), and both internal medicine and neurology had the lowest (each 76.1%).

According to the CMS, the new spending data were released “to help drive transformation of the health care delivery system.”

Sources: CMS; April 30, 2015; and Reuters; April 30, 2015.

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