Title: |
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Recent Trends in Prescription Drug Use and Expenditures by Medicaid Enrollees |
Description: |
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Background: As prescription drug expenditures consume an increasingly larger portion of Medicaid budgets, states are anxious to control drug costs without endangering enrollees' health. Objective: We use the 2001/02 and 2007/08 Medical Expenditure Panel Survey to analyze recent trends in Medicaid prescription drug expenditures by therapeutic classes and subclasses. Identifying the fastest growing categories of drugs, where drugs are grouped into clinically relevant classes and subclasses, can help inform policymakers' efforts to contain costs.
Findings: We found that total drug expenditures for Medicaid enrollees increased by 47.4 percent from 2001/02 to 2007/08. In 2007/08, the top five therapeutic classes ranked by total annual expenditures were psychotherapeutic drugs, cardiovascular drugs, CNS agents, respiratory agents and antidiabetic agents, while the top five therapeutic subclasses were antipsychotics, anticonvulsants, antihyperlipidemics, asthma controller medications and antidepressants. More than a third (35.8 percent) of the estimated $42.1 billion in Medicaid drug expenditures was attributable to these five subclasses, which had expenditures totaling $15.1 billion in 2007/08. The percentage of prescriptions dispensed as generics increased from 45.4 to 60.0 percent during the period of our study. The fastest growing subclasses including antipsychotics, CNS stimulants, and angiotensin inhibitors had low rates of generic penetration and rapid increases in the population with use. In contrast, subclasses such as antihistamines and metformins had declining total expenditures as generic penetration increased and expenditures per user fell. |
Author(s): |
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Edward Miller and Eric M. Sarpong and Jessica S. Banthin |
Agency: |
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Rockville (MD): Agency for Healthcare Research and Quality |