Others titles
- Medicare Drug Spending Data 2016-2020
- Medicare Drug Cost and Drug Spending
- Medicare Part D Drug Cost and Utilization 2016-2020
Keywords
- Medicare
- CMS Drugs
- CMS Drug Costs
- Drug Utilization
- Medicare Spending
- Part D Drugs
Medicare Part D Drug Cost and Utilization Data 2016-2020
The 2020 Medicare Part D Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part D drugs (drugs patients generally administer themselves) and includes annual data for 2016 to 2020.
Get The Data
- ResearchNon-Commercial, Share-Alike, Attribution Free Forever
- CommercialCommercial Use, Remix & Adapt, White Label Log in to download
Description
Part D drug information is available from the Part D Prescription Drug Event (PDE) data and is available for a subset (~70%) of Medicare beneficiaries. For Part D drugs, spending is based on the gross drug cost, which represents total spending for the prescription claim, including Medicare, plan, and beneficiary payments.
PDE records were summarized by drug by linking National Drug Codes (NDCs), which are available in the PDE data, to the First Databank MedKnowledge database and aggregating by brand name and generic name. Any over-the-counter drugs in the PDE data were excluded from the analysis. Data from all Part D organization and plan types were included in the analysis. Data were aggregated across all strengths, dosage forms, and routes of administration, except for the unit cost change calculations, as described below.
The annual change in average cost per unit reflects the weighted percent change in average cost per unit from the prior year and is calculated for drugs utilized by more than 1,000 beneficiaries in both years. Since drugs are available in multiple strengths and dosage forms, the percentage change in unit cost was first calculated at the brand name, generic name, strength, dosage form, and route of administration level, and then a weighted average at the brand name and generic name level was calculated for inclusion in this file using the total number of claims as a weight. Note, manually calculating the percent change in unit cost using the overall “Average Cost per Unit” variables from each year may result in a difference between the weighted average percent change in unit cost reported in this file since the calculation does not account for differing strengths and dosage forms.
About this Dataset
Data Info
Date Created | 2020-01-21 |
---|---|
Last Modified | 2020-01-27 |
Version | 2020-01-27 |
Update Frequency |
Annual |
Temporal Coverage |
2016-2020 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare and Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Medicare, CMS Drugs, CMS Drug Costs, Drug Utilization, Medicare Spending, Part D Drugs |
Other Titles | Medicare Drug Spending Data 2016-2020, Medicare Drug Cost and Drug Spending, Medicare Part D Drug Cost and Utilization 2016-2020 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Brand_Name | First Databank Brand Name of the drug | string | required : 1 |
Generic_Name | First Databank Generic Name of the drug | string | required : 1 |
Number_Of_Manufacturers | Number of Medicare Part D Prescription Drug manufacturers. | integer | level : Ratio |
Total_Spending_2016 | Aggregate drug spending for the Part D program for 2016. | number | - |
Total_Dosage_Units_2016 | The sum of the dosage units of medication dispensed across the calendar year 2016 (e.g. number of tablets, grams, milliliters or other units). For Part D, the quantity of a drug in a dosage unit is the same as the quantity of the drug in a HCPCS billing unit. | number | level : Ratio |
Total_Claims_2016 | Number of Medicare Part D Prescription Drug Events for 2016. Includes original prescriptions and refills. | integer | level : Ratio |
Total_Beneficiaries_2016 | Number of Medicare Part D beneficiaries utilizing the drug for 2016. | integer | level : Ratio |
Average_Spending_Per_Dosage_Unit_2016 | Total Spending divided by the number of dosage units for 2016. For drugs with multiple strengths, dosage forms and routes of administration, this is a claim-weighted average unit cost | number | - |
Average_Spending_Per_Claim_2016 | Part D drug spending divided by the number of claims during the year 2016. | number | level : Ratio |
Average_Spending_Per_Beneficiary_2016 | Total Spending divided by the number of unique beneficiaries utilizing the drug (Beneficiary Count) during the benefit year 2016. | number | - |
Outlier_Flag_2016 | Set to 1 when outliers in data cause Average Spending per Dosage Unit to change by at least 10% and $1, or there are not enough records to identify outliers during the year 2016. The description of dataset contains additional details. | integer | level : Nominal |
Total_Spending_2017 | Aggregate drug spending for the Part D program for 2017. | number | - |
Total_Dosage_Units_2017 | The sum of the dosage units of medication dispensed across the calendar year 2017 (e.g. number of tablets, grams, milliliters or other units). For Part D, the quantity of a drug in a dosage unit is the same as the quantity of the drug in a HCPCS billing unit. | integer | level : Ratio |
Total_Claims_2017 | Number of Medicare Part D Prescription Drug Events for 2017. Includes original prescriptions and refills. | integer | level : Ratio |
Total_Beneficiaries_2017 | Number of Medicare Part D beneficiaries utilizing the drug for 2017. | integer | level : Ratio |
Average_Spending_Per_Dosage_Unit_2017 | Total Spending divided by the number of dosage units for 2017. For drugs with multiple strengths, dosage forms and routes of administration, this is a claim-weighted average unit cost | number | - |
Average_Spending_Per_Claim_2017 | Part D drug spending divided by the number of claims during the year 2017. | number | level : Ratio |
Average_Spending_Per_Beneficiary_2017 | Total Spending divided by the number of unique beneficiaries utilizing the drug (Beneficiary Count) during the benefit year 2017. | number | - |
Outlier_Flag_2017 | Set to 1 when outliers in data cause Average Spending per Dosage Unit to change by at least 10% and $1, or there are not enough records to identify outliers during the year 2017. The description of dataset contains additional details. | integer | level : Nominal |
Total_Spending_2018 | Aggregate drug spending for the Part D program for 2018. | number | - |
Total_Dosage_Units_2018 | The sum of the dosage units of medication dispensed across the calendar year 2018 (e.g. number of tablets, grams, milliliters or other units). For Part D, the quantity of a drug in a dosage unit is the same as the quantity of the drug in a HCPCS billing unit. | number | level : Ratio |
Total_Claims_2018 | Number of Medicare Part D Prescription Drug Events for 2018. Includes original prescriptions and refills. | integer | level : Ratio |
Total_Beneficiaries_2018 | Number of Medicare Part D beneficiaries utilizing the drug for 2018. | integer | level : Ratio |
Average_Spending_Per_Dosage_Unit_2018 | Total Spending divided by the number of dosage units for 2018. For drugs with multiple strengths, dosage forms and routes of administration, this is a claim-weighted average unit cost | number | - |
Average_Spending_Per_Claim_2018 | Part D drug spending divided by the number of claims during the year 2018. | number | level : Ratio |
Average_Spending_Per_Beneficiary_2018 | Total Spending divided by the number of unique beneficiaries utilizing the drug (Beneficiary Count) during the benefit year 2018. | number | - |
Outlier_Flag_2018 | Set to 1 when outliers in data cause Average Spending per Dosage Unit to change by at least 10% and $1, or there are not enough records to identify outliers during the year 2018. The description of dataset contains additional details. | integer | level : Nominal |
Total_Spending_2019 | Aggregate drug spending for the Part D program for 2019. | number | - |
Total_Dosage_Units_2019 | The sum of the dosage units of medication dispensed across the calendar year 2019 (e.g. number of tablets, grams, milliliters or other units). For Part D, the quantity of a drug in a dosage unit is the same as the quantity of the drug in a HCPCS billing unit. | number | level : Ratio |
Total_Claims_2019 | Number of Medicare Part D Prescription Drug Events for 2019. Includes original prescriptions and refills. | integer | level : Ratio |
Total_Beneficiaries_2019 | Number of Medicare Part D beneficiaries utilizing the drug for 2019. | integer | level : Ratio |
Average_Spending_Per_Dosage_Unit_2019 | Total Spending divided by the number of dosage units for 2019. For drugs with multiple strengths, dosage forms and routes of administration, this is a claim-weighted average unit cost | number | - |
Average_Spending_Per_Claim_2019 | Part D drug spending divided by the number of claims during the year 2019. | number | level : Ratio |
Average_Spending_Per_Beneficiary_2019 | Total Spending divided by the number of unique beneficiaries utilizing the drug (Beneficiary Count) during the benefit year 2019. | number | - |
Outlier_Flag_2019 | Set to 1 when outliers in data cause Average Spending per Dosage Unit to change by at least 10% and $1, or there are not enough records to identify outliers during the year 2019. The description of dataset contains additional details. | integer | level : Nominal |
Total_Spending_2020 | Aggregate drug spending for the Part D program for 2020. | number | - |
Total_Dosage_Units_2020 | The sum of the dosage units of medication dispensed across the calendar year 2020 (e.g. number of tablets, grams, milliliters or other units). For Part D, the quantity of a drug in a dosage unit is the same as the quantity of the drug in a HCPCS billing unit. | number | level : Ratio |
Total_Claims_2020 | Number of Medicare Part D Prescription Drug Events for 2020. Includes original prescriptions and refills. | integer | level : Ratio |
Total_Beneficiaries_2020 | Number of Medicare Part D beneficiaries utilizing the drug for 2020. | integer | level : Ratio |
Average_Spending_Per_Dosage_Unit_2020 | Total Spending divided by the number of dosage units for 2019. For drugs with multiple strengths, dosage forms and routes of administration, this is a claim-weighted average unit cost | number | - |
Average_Spending_Per_Claim_2020 | Part D drug spending divided by the number of claims during the year 2019. | number | level : Ratio |
Average_Spending_Per_Beneficiary_2020 | Total Spending divided by the number of unique beneficiaries utilizing the drug (Beneficiary Count) during the benefit year 2020. | number | - |
Outlier_Flag_2020 | Set to 1 when outliers in data cause Average Spending per Dosage Unit to change by at least 10% and $1, or there are not enough records to identify outliers during the year 2020. The description of dataset contains additional details. | integer | level : Nominal |
Percent_Change_In_Average_Spending_Per_Dosage_Unit_2020 | The percentage change in average spending per dosage unit for the year 2020 from the year 2019. | number | level : Ratio |
Percent_Annual_Growth_Rate_In_Avg_Spending_Per_Dosage_Unit_2016_2020 | The constant average change in spending per unit over the most recent five years (2016-2020) of data availability, calculated using the compound annual growth rate (CAGR). | number | level : Ratio |
Data Preview
Brand Name | Generic Name | Number Of Manufacturers | Total Spending 2016 | Total Dosage Units 2016 | Total Claims 2016 | Total Beneficiaries 2016 | Average Spending Per Dosage Unit 2016 | Average Spending Per Claim 2016 | Average Spending Per Beneficiary 2016 | Outlier Flag 2016 | Total Spending 2017 | Total Dosage Units 2017 | Total Claims 2017 | Total Beneficiaries 2017 | Average Spending Per Dosage Unit 2017 | Average Spending Per Claim 2017 | Average Spending Per Beneficiary 2017 | Outlier Flag 2017 | Total Spending 2018 | Total Dosage Units 2018 | Total Claims 2018 | Total Beneficiaries 2018 | Average Spending Per Dosage Unit 2018 | Average Spending Per Claim 2018 | Average Spending Per Beneficiary 2018 | Outlier Flag 2018 | Total Spending 2019 | Total Dosage Units 2019 | Total Claims 2019 | Total Beneficiaries 2019 | Average Spending Per Dosage Unit 2019 | Average Spending Per Claim 2019 | Average Spending Per Beneficiary 2019 | Outlier Flag 2019 | Total Spending 2020 | Total Dosage Units 2020 | Total Claims 2020 | Total Beneficiaries 2020 | Average Spending Per Dosage Unit 2020 | Average Spending Per Claim 2020 | Average Spending Per Beneficiary 2020 | Outlier Flag 2020 | Percent Change In Average Spending Per Dosage Unit 2020 | Percent Annual Growth Rate In Avg Spending Per Dosage Unit 2016 2020 |
1st Tier Unifine Pentips | Pen Needle,Diabetic | 1 | 216273.87 | 1052113.0 | 8913.0 | 3428.0 | 0.21 | 24.26 | 63.09 | 0.0 | 217938.04 | 1014318.0 | 8595.0 | 3025.0 | 0.22 | 25.36 | 72.05 | 0.0 | 167193.78 | 761658.0 | 6538.0 | 2341.0 | 0.22 | 25.57 | 71.42 | 0.0 | 139201.68 | 642471.0 | 5392 | 1878.0 | 0.22 | 25.82 | 74.12 | 0 | 118923.24 | 547006.0 | 4457 | 1595 | 0.22 | 26.68 | 74.56 | 0 | 0.42 | 1.28 |
1st Tier Unifine Pentips Plus | Pen Needle,Diabetic | 1 | 378040.97 | 1750907.0 | 14610.0 | 6564.0 | 0.22 | 25.88 | 57.59 | 0.0 | 402124.68 | 1850703.0 | 15403.0 | 5967.0 | 0.22 | 26.11 | 67.39 | 0.0 | 369402.85 | 1813908.0 | 14931.0 | 5674.0 | 0.2 | 24.74 | 65.1 | 0.0 | 343031.42 | 1830596.0 | 14581 | 5319.0 | 0.19 | 23.53 | 64.49 | 0 | 210217.15 | 1046616.0 | 8408 | 3905 | 0.2 | 25.0 | 53.83 | 0 | 7.18 | -1.8 |
Abacavir | Abacavir Sulfate | 8 | 19337054.97 | 4253483.0 | 66523.0 | 9008.0 | 4.55 | 290.68 | 2146.65 | 0.0 | 16793969.54 | 3985804.0 | 60831.0 | 8090.0 | 4.29 | 276.08 | 2075.89 | 0.0 | 14476732.05 | 3971677.0 | 54438.0 | 7359.0 | 4.04 | 265.93 | 1967.21 | 0.0 | 10511827.27 | 3422308.0 | 44259 | 6085.0 | 3.49 | 237.51 | 1727.5 | 0 | 9241054.74 | 2972406.0 | 37325 | 5068 | 3.49 | 247.58 | 1823.41 | 0 | -0.09 | -6.41 |
Abacavir-Lamivudine | Abacavir Sulfate/Lamivudine | 6 | 14755782.09 | 439840.0 | 13906.0 | 6631.0 | 33.55 | 1061.11 | 2225.27 | 0.0 | 51251796.33 | 2503870.0 | 80654.0 | 10465.0 | 20.42 | 635.45 | 4897.45 | 0.0 | 24580930.14 | 2224864.0 | 70470.0 | 8681.0 | 11.06 | 348.81 | 2831.58 | 1.0 | 19441270.39 | 1693617.0 | 50235 | 6423.0 | 11.47 | 387.01 | 3026.82 | 0 | 14847197.71 | 1379151.0 | 37758 | 4752 | 10.78 | 393.22 | 3124.41 | 0 | -6.06 | -24.72 |
Abacavir-Lamivudine-Zidovudine | Abacavir/Lamivudine/Zidovudine | 1 | 12787721.57 | 608455.0 | 9768.0 | 1333.0 | 21.02 | 1309.14 | 9593.19 | 0.0 | 10158493.71 | 468341.0 | 7451.0 | 971.0 | 21.69 | 1363.37 | 10461.89 | 0.0 | 6955321.12 | 330735.0 | 5298.0 | 710.0 | 21.03 | 1312.82 | 9796.23 | 0.0 | 4849598.99 | 225020.0 | 3648 | 493.0 | 21.55 | 1329.39 | 9836.91 | 0 | 2085404.63 | 96333.0 | 1585 | 290 | 21.65 | 1315.71 | 7191.05 | 0 | 0.45 | 0.74 |
Abelcet | Amphotericin B Lipid Complex | 1 | 752938.84 | 85650.0 | 476.0 | 140.0 | 8.79 | 1581.8 | 5378.13 | 1.0 | 675695.03 | 68490.0 | 420.0 | 137.0 | 9.87 | 1608.8 | 4932.08 | 0.0 | 766166.41 | 101857.38 | 620.0 | 205.0 | 7.52 | 1235.75 | 3737.4 | 0.0 | 618247.3 | 120570.0 | 777 | 226.0 | 5.13 | 795.69 | 2735.61 | 0 | 637913.66 | 124320.0 | 826 | 238 | 5.13 | 772.29 | 2680.31 | 0 | 0.07 | -12.59 |
Abilify Maintena | Aripiprazole | 1 | 201823387.97 | 117225.31 | 116208.0 | 17154.0 | 1721.56 | 1736.74 | 11765.38 | 0.0 | 261850803.04 | 138043.0 | 137385.0 | 19543.0 | 1896.96 | 1905.96 | 13398.7 | 0.0 | 345893454.06 | 165452.47 | 164759.0 | 22935.0 | 2090.8 | 2099.39 | 15081.47 | 0.0 | 422038582.34 | 189937.35 | 189140 | 25421.0 | 2222.07 | 2231.36 | 16601.97 | 0 | 460313112.01 | 204264.77 | 203218 | 25646 | 2253.59 | 2265.12 | 17948.73 | 0 | 1.42 | 6.96 |
Abilify Mycite | Aripiprazole | 1 | 40552.86 | 720.0 | 24 | 56.32 | 1689.7 | 1 | 92372.21 | 1620.0 | 47 | 15 | 56.91 | 1965.37 | 6158.15 | 1 | 1.04 | 1.04 | ||||||||||||||||||||||||||
Abilify | Aripiprazole | 1 | 92466456.99 | 2936202.25 | 97635.0 | 39255.0 | 31.48 | 947.06 | 2355.53 | 0.0 | 37757403.48 | 1158483.0 | 32241.0 | 6955.0 | 32.72 | 1171.1 | 5428.81 | 0.0 | 31071646.36 | 950552.33 | 25660.0 | 4690.0 | 32.84 | 1210.9 | 6625.08 | 0.0 | 26854630.75 | 808281.5 | 20939 | 3670.0 | 33.4 | 1282.52 | 7317.34 | 0 | 24481910.61 | 716447.5 | 17689 | 2532 | 34.44 | 1384.02 | 9669.0 | 0 | 3.1 | 2.27 |
Abiraterone Acetate | Abiraterone Acetate | 16 | 26623436.37 | 435123.0 | 3624.0 | 3328.0 | 61.15 | 7346.42 | 7999.83 | 0.0 | 512999622.52 | 11525569.0 | 98721 | 17787.0 | 44.44 | 5196.46 | 28841.27 | 0 | 501248299.37 | 17304684.0 | 152068 | 23638 | 28.97 | 3296.21 | 21205.19 | 0 | -34.81 | -31.17 |