Looking inside the nation's medicine cabinet: Trends in outpatient drug spending by medicare beneficiaries, 1997 and 2001

Health Affairs

Volumn 23, Issue 5, 2004, Pages 217-225

  Moeller, John F ^a   Miller, G Edward ^a   Banthin, Jessica S ^a  

^a Agy for Hlthcare Res and Quality   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST EFFECTIVENESS ANALYSIS; DRUG COST; DRUG PREFERENCE; ECONOMIC ASPECT; HEALTH CARE FINANCING; HEALTH SURVEY; HUMAN; MEDICARE; OUTPATIENT CARE; POPULATION RESEARCH; PRESCRIPTION;

AMBULATORY CARE; DRUG COSTS; HEALTH EXPENDITURES; HUMANS; MEDICARE; PHARMACEUTICAL PREPARATIONS; UNITED STATES;

EID: 4644372213     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.23.5.217     Document Type: Article

References (18)

1. K. Levit et al. "Inflation Spurs Health Spending in 2000," Health Affairs 21, no. 1 (2002): 172-181.
2. C.P. Thomas, G. Ritter, and S. Wallack, "Growth in Prescription Drug Spending among Insured Elders," Health Affairs 20, no. 5 (2001): 265-277; R. Dubois et al., "Explaining Drug Spending Trends: Does Perception Match Reality?" Health Affairs 19, no. 2 (2000): 231-239; and M. Merlis, Explaining the Growth in Prescription Drug Spending: A Review of Recent Studies, Report for USDHHS Conference on Pharmaceutical Pricing Practices, Utilization, and Costs (Washington: Institute for Health Policy Solutions, 2000).
3. C.P. Thomas, G. Ritter, and S. Wallack, "Growth in Prescription Drug Spending among Insured Elders," Health Affairs 20, no. 5 (2001): 265-277; R. Dubois et al., "Explaining Drug Spending Trends: Does Perception Match Reality?" Health Affairs 19, no. 2 (2000): 231-239; and M. Merlis, Explaining the Growth in Prescription Drug Spending: A Review of Recent Studies, Report for USDHHS Conference on Pharmaceutical Pricing Practices, Utilization, and Costs (Washington: Institute for Health Policy Solutions, 2000).
4. C.P. Thomas, G. Ritter, and S. Wallack, "Growth in Prescription Drug Spending among Insured Elders," Health Affairs 20, no. 5 (2001): 265-277; R. Dubois et al., "Explaining Drug Spending Trends: Does Perception Match Reality?" Health Affairs 19, no. 2 (2000): 231-239; and M. Merlis, Explaining the Growth in Prescription Drug Spending: A Review of Recent Studies, Report for USDHHS Conference on Pharmaceutical Pricing Practices, Utilization, and Costs (Washington: Institute for Health Policy Solutions, 2000).
5. S.B. Cohen, Sample Design of the 1996 Medical Expenditure Panel Survey Household Component, MEPS Methodology Report no. 2, Pub. no. 97-0027 (Rockville, Md.: Agency for Healthcare Research and Quality, 1997).
6. J.F. Moeller et al., Outpatient Prescription Drugs: Data Collection and Editing in the 1996 Medical Expenditure Panel Survey, Pub. no. 01-0002 (Rockville, Md.: AHRQ, June 2001).
7. Approximately 4.5 percent of drug purchases linked to more than one therapeutic class and were assigned to a unique class using a combination of condition information and random assignment. About 1 percent of drug purchases could not be linked to Multum.
8. The percentage growth in spending is equal to the growth in the population with use times the growth in prescriptions per user times the growth in the average prescription price. For example, for aggregate drug expenditures: 1.716 = (1.099) × (1.236) × (1.263).
9. All other results mentioned in the text are significant at the .05 level unless otherwise noted. The price measure is technically not a pure measure of price because prescription prices are not standardized for days supply and strength. See Merlis, Explaining the Growth.
10. We do not present results on out-of-pocket payments by therapeutic class. We find that for less (more) costly drug classes, a relatively high (low) percentage is financed by out-of-pocket payments. This is probably attributable to the presence of fixed copayments for drugs. We also find that the percentage paid out of pocket within therapeutic classes and subclasses was stable from 1997 to 2001.
11. Therapeutic classes that accounted for less than 3 percent of spending were not included in the exhibits. The fifteen subclasses were all in the top ten in purchases or spending, or both, in at least one year, 1997 or 2001.
12. B.T. Vanderhoff and R.M. Tahboub, "Proton Pump Inhibitors: An Update," American Family Physician 66, no. 2 (2002): 273-280.
13. We find evidence of considerable off-label use of psychotherapeutic drugs among Medicare beneficiaries (for example, use of valium to treat a sleep disorder or pain, rather than to treat anxiety).
14. J.A. Doshi, N. Brandt, and B. Stuart, "The Impact of Drug Coverage on COX-2 Inhibitor Use in Medicare," Health Affairs, 18 February 2004, content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.94 (3 June 2004).
15. See, for example, S. Foote and L. Etheredge, "Increasing Use of New Prescription Drugs," Health Affairs 19, no. 4 (2000): 165-170; Merlis, Explaining the Growth; Thomas et al., "Growth in Prescription Drug Spending"; and C.W. Burt, "National Trends in Use of Medications in Office-Based Practice, 1985-1999," Health Affairs 20, no. 4 (2002): 206-214.
16. See, for example, S. Foote and L. Etheredge, "Increasing Use of New Prescription Drugs," Health Affairs 19, no. 4 (2000): 165-170; Merlis, Explaining the Growth; Thomas et al., "Growth in Prescription Drug Spending"; and C.W. Burt, "National Trends in Use of Medications in Office-Based Practice, 1985-1999," Health Affairs 20, no. 4 (2002): 206-214.
17. See, for example, S. Foote and L. Etheredge, "Increasing Use of New Prescription Drugs," Health Affairs 19, no. 4 (2000): 165-170; Merlis, Explaining the Growth; Thomas et al., "Growth in Prescription Drug Spending"; and C.W. Burt, "National Trends in Use of Medications in Office-Based Practice, 1985-1999," Health Affairs 20, no. 4 (2002): 206-214.
18. See, for example, S. Foote and L. Etheredge, "Increasing Use of New Prescription Drugs," Health Affairs 19, no. 4 (2000): 165-170; Merlis, Explaining the Growth; Thomas et al., "Growth in Prescription Drug Spending"; and C.W. Burt, "National Trends in Use of Medications in Office-Based Practice, 1985-1999," Health Affairs 20, no. 4 (2002): 206-214.