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December 20, 2015 11:00 PM

CMS posts new view of drug spending amid mounting tension on costs

Virgil Dickson
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    More Medicare beneficiaries were prescribed AstraZeneca's cholesterol drug Crestor than any other prescription medication last year, but the government spent 20% more on Sovaldi, Gilead's new blockbuster hepatitis C drug.

    That's according to a new Web page the CMS posted intended to shed light on prescription drug use and spending. The analysis comes amid rising pressure from the public, lawmakers and presidential candidates for more scrutiny of rising drug prices.

    Medicare paid about $3 billion for just over 33,000 beneficiaries to get Sovaldi and $2.5 billion for the 1.7 million enrollees receiving Crestor. Per beneficiary, United Therapeutics Corp.'s Remodulin had the highest cost at $133,000. Just over 1,000 program enrollees received the drug last year.

    The online dashboard launched Monday reflects drugs prescribed under Part B—administered in doctors' offices and other outpatient settings—and Part D, the program's general prescription drug benefit.

    “By sharing this information and allowing people to analyze the data, we can increase the knowledge around drug spending and support efforts that are evaluating whether public dollars are being spent most effectively,” acting CMS Administrator Andy Slavitt said in a blog post about the data.

    At some point next year, the agency hopes to release similar data for Medicaid, said Niall Brennan, chief data officer and director in CMS' Office of Enterprise Data and Analytics.

    The new dashboard shows the top 80 drugs received by Medicare beneficiaries. The medications represent 33% of all Part D spending and 71% of Part B drug spending in 2014, or $55 billion of about $143 billion in Medicare prescription drug spending that year.

    The data does not, however, reflect the net prices paid to manufacturers or the rebates to plans and prescription benefit managers. In the Part D program, the CMS is not permitted to disclose the rebates paid by manufacturers to Part D plan sponsors. Under Part B, Medicare does not receive a rebate but pays 106% of the estimated average sales price of each drug, which reflects the average prices paid by physician offices and hospital outpatient departments, accounting for discounts and rebates.

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