Washington - Medicare spent $143 billion on drugs last year-- a sum that pushed drug spending up from 10 percent of the total budget in 2010 to 14 percent last year. The database that details the federal spending, made up about a third of the total drug expenditures last year. They were either the top bills paid by Medicare, the highest per-patient cost or had the biggest price increases between 2013 and 2014.
Two takeaways:
- The new $84 000 hepatitis C drug hit Medicare hard - but so did price increases.
- The Sovaldi effect dramatically demonstrates why tracking overall spending is crucial.
The hepatitis C drug, which was the subject of a recent Senate investigation for its $84 000 price tag, was the largest single contributor to Medicare drug expenses in 2014, costing $3.1 billion. The other drugs that swallow a large swath of the drug spending budget also showed price increases and had a big impact on federal spending.
The number of people using Nexium, an acid reflux medication, decreased somewhat over the five years, but the price per unit went up about 40 percent in that time - leading to about $800 million more in spending for Medicare. The most expensive drugs for Medicare aren't necessarily the most expensive for patients.
There's sometimes a disconnect between the drugs that are driving overall health spending and the ones sending patients home with staggering bills.
And those drugs that take the biggest toll may not always be the same. One of the biggest outlays for the Medicare program overall was the antipsychotic drug, Abilify, which cost Medicare more than $2.5 billion in 2014. The annual spending on the drug added up to more than $6 000 a year per beneficiary, but the average portion borne by the patient was $552 a year. The vast majority of the people taking the drug, who were on a low-income subsidy, would pay even less: about $20 a year.
That means it's also important to examine the biggest drugs as measured by how much patients paid. For Medicare Part D, that included Sovaldi, but also included drugs that cost Medicare far less.
The data show the many ways there are to measure prescription drug spending: There's the toll it takes on the overall system, the toll it takes on the patient and the raw price tag for a bottle of medication or an injection. Sometimes, these facets of a drug's price overlap and the drivers of one kind of spending are the same as another. But other times, they highlight a different set of drugs entirely, suggesting that coming up with a strategy to rein in spending will need to take into account all the ways in which high prices can matter.
THE WASHINGTON POST