US releases data on Medicare Part D spending, led by Nexium, Advair

According to data released by the US Centers for Medicare & Medicaid Services (CMS), around $103.7 billion worth of prescriptions were filled under Medicare Part D in 2013, with four branded medicines accounting for nearly 10 percent of this. AstraZeneca's Nexium (esomeprazole) led the list with prescriptions totalling $2.5 billion, followed by $2.3 billion for GlaxoSmithKline's Advair (fluticasone/salmeterol), AstraZeneca's Crestor (rosuvastatin) with $2.2 billion of prescriptions and Otsuka's Abilify (aripiprazole) with $2.1 billion.

The figures represent the first time that data on Medicare Part D, which covers about 35.7 million people, has been released. "This transparency will give patients, researchers and providers access to information that will help shape the future of our nation's health for the better," commented acting CMS administrator Andy Slavitt. Sean Cavanaugh, CMS deputy administrator, added "there are many, many smart minds in this country and we want to unleash them on this data." The agency said it intends to release the information annually.

The data showed that joint sales of two versions of Sanofi's Lantus (insulin glargine), one delivered via the company's SoloStar pen, totalled $2.7 billion and would have topped the list if revenue was combined. The analysis found that although the 10 highest prescribed drugs were branded medicines, the top 10 by number of claims were all generics. The most-prescribed Medicare drug was lisinopril with 36.9 million prescriptions, followed by simvastatin with 36.7 million and levothyroxine with 35.2 million.

Further data indicated that of the nearly 3500 medicines prescribed in 2013, around 400 costing $3000 or more per beneficiary added up to $26.5 billion. The drugs, which include Celgene's Revlimid (lenalidomide) and Teva's Copaxone (glatiramer acetate), accounted for 26 percent of total spending, but just 1 percent of claims. Overall, the Medicare programme spent around $551 billion in 2013, including $243 billion on hospitals and $130 billion on physicians and clinical services.

In response to the data, Pharmaceutical Research and Manufacturers of America said that the findings were "misleading" because insurers often negotiate rebates as high as 20 percent to 30 percent for branded medications.

For related analysis, read Spotlight On: Obama puts Medicare Part D in the crosshairs – but are changes likely? and ViewPoints: Medicare spending on HCV drugs jumps in 2014 – was it money well spent?

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