Title: |
|
Evaluating an Alternative Data Source for Editing MEPS Drug Prices |
Description: |
|
Currently, the Medical Expenditure Panel Survey (MEPS) follow-back survey of pharmacies relies on the average wholesale unit price (AWUP) as a benchmark for identifying outlier prices. We assessed a potential alternative benchmark: median retail unit prices (RUPs) calculated from the MarketScan's database of private claims. Both the AWUP and median RUP are at the National Drug Code level. Using MarketScan and Medicare Part D claims data, we showed graphically the similarity of the distributions of unit prices for private insurance and Medicare Part D. This suggests that the median RUP may be useful for editing prices for two payment sources: private and Medicare. These two sources paid for 59.8% of drug expenditures in the MEPS population. Then we compared the accuracy of editing rules based on the AWUP and median RUP using a sample of MEPS pharmacy data validated by matching to Medicare Part D claims. In this selected sample, using the median RUP instead of the AWUP would slightly increase the accuracy of edited prices for generics and single source brand name drugs. We applied both sets of editing rules to the 2007 MEPS pharmacy data and found similar edited generic prices, but the prices of brand name drugs would be somewhat lower using the median RUP. Thus, it is feasible but not particularly necessary to change the unit price benchmark.
Changing the benchmark would likely slightly improve accuracy but create a small break in the comparability over time in the prices of brand name drugs and aggregate expenditures. |
Author(s): |
|
Marc Zodet and Steven C. Hill and Samuel Zuvekas |
Agency: |
|
Rockville (MD): Agency for Healthcare Research and Quality |
Back
Email Updates
