Medicare Spending on Essential Medicines Up 116 Percent From 2011 to 2015

Spending associated with essential medicines grew substantially from 2011 to 2015 for Medicare Part D beneficiaries, according to a study published online in The BMJ.

David G. Li, M.D., from Brigham and Women's Hospital in Boston, and colleagues used data from the Medicare Part D Prescriber Public Use File (2011 through 2015) to characterize trends in spending by U.S. Medicare Part D beneficiaries for medicines deemed essential by the World Health Organization.

The researchers found that Medicare Part D expenditure on 265 WHO essential medicines was $87.2 billion from 2011 through 2015, with annual spending increasing from $11.9 billion in 2011 to $25.8 billion in 2015 (116 percent increase). During the same time period, patients' out-of-pocket spending for essential medicines was $12.1 billion, a 47 percent increase in annual out-of-pocket spending and a 4 percent increase in annual per beneficiary out-of-pocket spending. Total prescription count increased by 33 percent (from 376.1 million to 498.9 million), while the cumulative beneficiary count grew 42 percent (from 95.9 million to 135.8 million). The per-unit cost of half of the included essential medicines increased faster than the average inflation rate. More than half of the increase in total spending (58 percent) was attributed to the introduction of novel agents, particularly to treat hepatitis C.

"These trends may limit patients' access to essential drugs while also increasing health care system costs," the authors write.

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