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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.