Trends: Changes in medicaid prescription volume and use in the wake of medicare part D implementation

Health Affairs

Volumn 27, Issue 1, 2008, Pages 196-202

  Bruen, Brian K ^a   Miller, Laura M ^b  

^a Avalere Health LLC   (United States)

^b National Association of Chain Drug Stores   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DRUG CLASSIFICATION; DRUG COST; HEALTH SERVICE; MEDICAID; MENTAL HEALTH; PHARMACY; POPULATION; PRESCRIPTION; REIMBURSEMENT; BUDGET; DRUG UTILIZATION; ECONOMICS; GOVERNMENT; HEALTH CARE PLANNING; HUMAN; LEGAL ASPECT; MEDICARE; ORGANIZATION AND MANAGEMENT; UNITED STATES;

BUDGETS; CENTERS FOR MEDICARE AND MEDICAID SERVICES (U.S.); DRUG UTILIZATION; ELIGIBILITY DETERMINATION; HUMANS; MASSACHUSETTS; MEDICAID; MEDICARE PART D; PRESCRIPTIONS, DRUG; STATE HEALTH PLANS; UNITED STATES;

EID: 38849158560     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.27.1.196     Document Type: Article

References (11)

1. Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Expenditure Accounts.
2. B. Bruen and A. Ghosh, Medicaid Prescription Drug Spending and Use (Washington: Kaiser Commission on Medicaid and the Uninsured, June 2004).
3. In the time since this paper was written, the 2006 spending numbers from the CMS have been released. They show that Medicaid spending did decrease as a source of funding for retail prescription drugs, from 19 percent in 2005 to 9 percent in 2006. A pie chart showing the changes from 2005 to 2006 is available elsewhere in this issue. See A. Catlin et al., "National Health Spending in 2006: A Year of Change for Prescription Drugs," Health Affairs 27, no. 1 (2008): 19.
4. States must make "phased-down state contribution" payments to the federal government - often called the "clawback" - to offset part of the cost of drug coverage for dual eligibles under Medicare Part D. Each state pays a percentage of the total projected Medicare drug payments for dual eligibles in the state. That percentage, which started at 90 percent in 2006, will be lowered each year until 2015, when it will be fixed at 75 percent. The percentage is 88.33 percent for 2007.
5. CMS, "State Drug Utilization Data," 1 October 2007, http://www.cms.hhs.gov/MedicaidDrugRebateProgram/SDUD/list.asp (accessed 4 October 2007).
6. Medicaid drug spending in 2006 equaled about $20.3 billion in constant ("real") 2005 dollars, using the average Consumer Price Index for all goods and services purchased for consumption by urban households (CPI-U) as the measure of inflation.
7. "Medicaid Program; Prescription Drugs; Final Rule," Federal Register 72, no. 136 (17 July 2007): 39230.
8. Medicaid is jointly funded by states and the federal government. States receive federal matching funds covering a minimum of half of their qualifying expenditures onmedical services under the program.
9. Express Scripts, Drug Trend Report 2006 (St. Louis: Express Scripts, April 2007), 3.
10. CMS, "Part D Performance Data," 8 February 2007, http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/06_PerformanceData.asp (accessed 30 August 2007).
11. D.P. Chapman, G.S. Perry, and T.W. Strine, "The Vital Link between Chronic Disease and Depressive Disorders," Preventing Chronic Disease 2, no. 1 (2005), http://www.cdc.gov/pcd/issues/2005/jan/04_0066.htm (accessed 6 August 2007).