Neurology – Five-Year Trends in Payment for Neurologist-Prescribed Drugs in Medicare Part D

Five-Year Trends in Payment for Neurologist-Prescribed Drugs in Medicare Part D

Objective

To determine whether there was an increase in payments for neurologist-prescribed drugs, we performed a retrospective analysis of prescription claims in the Medicare Part D Prescriber Public Use Files from 2013-2017.

Results and Conclusions

The researchers reviewed 520 drugs, of which 322 were generic (GEN), 61 brand name only (BNO), and 137 brand name prescribed even though a generic equivalent is available (BNGE), representing 90,716,536 claims. While the number of claims from 2013 to 2017 only increased 7.6%, the total payment increased 50.4%. Adjusted for inflation, claim payments for GEN drug increased 0.6%, compared to significant increases in BNO and BNGE drugs of 42.4% and 45.0%, respectively.

Payments for neurologist-prescribed brand name, but not generic, drugs in Medicare Part D increased consistently and well above inflation from 2013-2017. Unless the overall trend stabilizes or is reversed, or high cost-to-claim drugs are addressed, this trend will place an increasing burden on the neurologic Medicare budget.