CMS Updates Drug Spending Dashboards in Transparency Effort

CMS recently updated its drug spending dashboards with data for 2017, displaying pricing and spending data for thousands of drugs across Medicare Parts B and D and Medicaid.

In 2017, total gross spending on prescription drugs was $154.9 billion in Medicare Part D, $30.4 billion in Part B, and $67.6 billion in Medicaid.

The drug dashboards last updated in May of last year. The administration said it is part of its effort to improve transparency around drug pricing; the administration also wants to shift some Part B coverage to Part D as part of its plan to reduce total drug spending, with the idea that Part D plan sponsors would have more negotiating room with pharmaceutical companies.

The dashboards focus on average spending per dosage unit for prescription drugs and track the change in average spending per dosage unit over time. The web-based tool (or the downloadable spreadsheet, which has more information) can be sorted by manufacturer, drug, price, and more.

“The dashboards pinpoint the sources of rising prescription drug prices to help guide our continued work to address this problem,” said CMS Administrator Seema Verma. She said that, from 2013-2017, prescription drug spending grew at an average annual rate of 10.6% in Medicare Part D, 10% in Part B, and 14.8% in Medicaid.

Verma said in her statement that the tool could be used, for instance, to help doctors and patients compare prices.

However, while the CMS spreadsheets include the number of manufacturers available for a given drug, they do not indicate whether a biosimilar is available for brand-name biologics.

Some of the cost increases for brand-name biologic products include the following:

• In Medicare Part B, insulin lispro, sold as Humalog, saw a 242.76% increase in the average spending per dosage unit from 2016 to 2017, and a 36.84% annual growth rate in average spending per dose from 2013 to 2017.
• The average spending per dosage unit for infliximab (Remicade) in Part B rose 4.2% to $83.57 in 2017; the drug totaled $1.34 billion in Part B spending. In Part D, the average cost per dosage unit of the same product rose 28.3% to $1041.87, up from $812.27; there were $83 million in spending in 2017. No data are listed for infliximab biosimilars Inflectra or Renflexis.
• For etanercept (Enbrel), the change in average spending per dosage unit rose 14.29% to $1066.53 in Part D.
• For bevacizumab (Avastin), the average spending per dosage unit rose nearly 7% to $192.98 in 2017 in Part D, for nearly $24 million in Part D spending. In Part B, the average spending per dosage unit rose 3.9% to $72.74, costing $1 billion in all of 2017.