On August 18, 2016, the Centers for Medicare and Medicaid Services (CMS) released new prescription drug data, physician-level data on prescriptions for drugs paid for by Medicare Part D in 2014. This new data set “describes the specific medications prescribed for 38 million Medicare Part D enrollees, who represent about 70 percent of all Medicare beneficiaries.” This is the second annual release of the data.
According to Niall Brennan, CMS Chief Data Officer, “With this data release, patients, researchers and providers can access valuable information about the Medicare prescription drug program. Today’s release joins a series of actions the Administration is taking to improve transparency around government data, including the cost of prescription drugs.”
The 2014 data set contains information from over one million distinct health care providers who collectively prescribed roughly $121 billion in prescription drugs that were paid for under the Medicare Part D program, a seventeen percent increase from the 2013 data set numbers. This falls more or less in line with a March 2016 Health and Human Services (HHS) report, which provided a detailed analysis of prescription drug spending trends and noted that the overall prescription drug spending in the United States rose by 12.6 percent from 2013 to 2014.
In 2014, Lisinopril, Levothyroxine Sodium, and Amlodipine Besylate were the three drugs with the highest claim count. Rounding out that top ten list were Hydrocodone-Acetaminophen, Omeprazole, Metformin HCI, and Gabapentin.
Interestingly, none of the drugs in the top ten list by claim count were in the top ten drugs by costs. At the top of that list were: Sovaldi ($3.1 billion), Nexium ($2.66 billion), and Crestor ($2.54 billion). Also on that list were Abilify ($2.53 billion), Lantus SoloSTAR ($2 billion), and Revlimid ($1.67 billion).
The data set was created by using information submitted by Medicare Advantage Prescription drug plans, as well as stand-alone Prescription Drug Plans. Now that there are two years of data, analyses of trends from 2013 to 2014 will be possible, as well as “a wide array of analyses that compare prescribing habits for specific providers, brand versus generic drug prescribing rates, and state- and local-level differences in drug utilization and costs.
The 2014 data set also includes new aggregated information on opioids, antibiotics, antipsychotics, and high-risk medications among the elderly. Additionally, a prescriber enrollment status field has been added to indicate whether the prescriber is enrolled, not enrolled, or has opted out of the Medicare program.
This new data adds to the current trove of information previously released on services and procedures provided to Medicare beneficiaries. According to CMS, “[t]his public data release is part of the Administration’s broader strategy to improve the health care system by paying practitioners for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality.”