Managed Care

 

Government payers shouldering more Rx payments

MANAGED CARE June 2011. © MediMedia USA
The Formulary Files

Government payers shouldering more Rx payments

MANAGED CARE June 2011. ©MediMedia USA

A recent report from the IMS Institute for Healthcare Informatics suggests a continuing shift toward government payers (Medicare and Medicaid) to help beneficiaries pay for prescription medications.

Commercial insurance was used to pay for 63 percent of dispensed prescriptions in 2010, according to the report, The Use of Medicines in the United States: Review of 2010. That is down from 66 percent five years ago. Thirty percent of all prescriptions in 2010 were filled under a Part D plan or through Medicaid. That number was 22 percent in 2006 — a clear indication of greater dependence on government programs for medications. Part D was launched in 2006.

The report attributes the changes to the slow growth of the economy in 2010 and high unemployment.

The institute found that Part D beneficiaries filled 871 million prescriptions in 2010, up 6.4 percent and accounting for nearly 22 percent of all prescriptions. Medicaid prescriptions increased by 13.7 percent, to 336 million, in 2010.

Cash payments declined by 10.3 percent, to 273 million prescriptions. Private insurance accounted for 62.9 percent of prescriptions in 2010, versus 64.1 percent in 2009.

The report says total spending on medications was $307.4 billion in 2010, up from $300.3 billion in 2009. There was an $8.3 billion decline in the volume of branded product spending in 2010 compared to 2009. Brands losing patent protection or exclusivity in 2010 resulted in a reduction in spending of $12.6 billion.

Dispensed prescriptions by payment type

Source: IMS Institute for Healthcare Informatics. The Use of Medicines in the United States: Review of 2010.

Meetings

2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
6th Semi-Annual Diagnostic Coverage and Reimbursement Conference Boston December 4–5, 2014
Customer Analytics & Engagement in Health Insurance Chicago December 4–5, 2014
Pharmaceutical and Biotech Clinical Quality Assurance Conference Alexandria, VA December 4–5, 2014
9th Semi-Annual Medical Device Coverage and Reimbursement Conference San Diego December 5, 2014
8th Annual Medical Device Clinical Trials Conference Chicago December 8–9, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015