The 10 costliest drugs covered by Medicare Part D

May 04, 2015 at 09:04 PM
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Fourteen different drugs topped the $1 billion mark in 2013, among them well-known names like Nexium, Crestor and Cymbalta. This information published as part of a new dataset released on April 30 by the Centers for Medicare and Medicaid Services (CMS). The report gathered an unprecedented level of information from more than one million health care providers who collectively prescribed $103 billion in prescription drugs under the program.

2013 is the most recent year for which CMS has data on drug usage and costs for the 36 million people who are enrolled in the Part D program (approximately 68 percent of all Medicare patients). The data accounts for the total number of prescriptions that were dispensed, including original prescriptions and any refills, and the total drug cost paid by beneficiaries, part D plans and other sources. 

Among other data points, the report tracked prescription methods by Hospital Referral Regions, identifying which states have the lowest generic dispensing rate (Texas, Alaska and Hawaii all made the list) and which states have the highest rate (Washington, Oregon, and much of the West coast, among others).

CMS was clear about the intent behind making this data public: to lower spending on prescription drugs. Their fact sheet on the data notes, "This new dataset provides key information to consumers, providers, researchers, and other stakeholders to help drive transformation of the health care delivery system. This data enables a wide range of analyses on the type of prescription drugs prescribed in the Medicare Part D program, and on prescription drug utilization and spending generally."

For the ten costliest drugs paid for by Medicare Part D in 2013, read on.

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1. Nexium (Gastrointestinal)

Number of beneficiaries: 1,484,011

Number of claims: 8,192,362

Total drug cost (in billions): $2.53

Image: NEXIUM(TM) (esomeprazole magnesium) 40 mg and 20 mg 30-count capsule bottles. (PRNewsFoto/AstraZeneca)

 

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2. Advair Diskus (Asthma)

Number of beneficiaries: 1,527,217

Number of claims: 6,605,423

Total drug cost (in billions): $2.26

Image: In this Oct. 15, 2013 file photo, Carter Howard sits and watches a cartoon during his asthma treatment at his home in Northbrook, Ill. A new survey suggests asthma in the U.S. may finally be on the decline, according to the findings from a large national health survey conducted in 2013. The report was released by the centers for Disease Control and Prevention. (AP Photo/Charles Rex Arbogast, File)

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3. Crestor (Cardiovascular drugs)

Number of beneficiaries: 1,732,787

Number of claims: 9,066,409

Total drug cost (in billions): $2.22

Image: Greg Ameo, a 53 year old retired transit worker, poses for a photograph in his garage at this home in the Bronx borough of New York, Thursday, June 19, 2008. Like many men his age, Ameo struggles with high blood pressure and cholesterol. He hates pills, but accepts them grudgingly. He eats healthier than he used to and takes walks for exercise. He takes fish oil and garlic, in case they might help with the cholesterol. (AP Photo/Tina Fineberg)

 

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4. Abilify (Psychotherapeutic drug)

Number of beneficiaries: 396,764

Number of claims: 2,886,837

Total drug cost (in billions): $2.11

Image: A sign stands in front of the Bristol-Myers Squibb Company's headquarters in Lawrence Township, N.J., Wednesday, June 15, 2005. Bristol-Myers Squibb, along with Otsuka Pharmaceuticals, is the maker of Abilify. (AP Photo/Mel Evans)

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5. Cymbalta (Psychotherapeutic drug)

Number of beneficiaries: 1,032,774

Number of claims: 6,887,543

Total drug cost (in billions): $1.96

Image: Containers of the drugs Cialis and Cymbalta, made by Eli Lilly & Co., are pictured on shelf at Nora Apothecary Pharmacy in Indianapolis, Monday, April 20, 2009. (AP Photo/Darron Cummings)

 

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6. Spiriva (Asthma)

Number of beneficiaries: 1,181,599

Number of claims: 5,735,127

Total drug cost (in billions): $1.96

Image: In this Sept. 15, 2011 photo, Judith Odyssey sets up her weekly medication, in Hartford, Maine. Odyssey, who has congestive heart problems, fibromyalgia, asthma and arthritis, gets $674 a month in Social Security. (AP Photo/Robert F. Bukaty)

 

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7. Namenda (Central nervous system drugs)

Number of beneficiaries: 798,714

Number of claims: 6,878,399

Total drug cost (in billions): $1.56

Image: Fernando Barbosa, of Malden, Mass., participates in Genzyme's interactive exhibit designed to raise awareness of Multiple Sclerosis in Boston, Wednesday, Sept. 10, 2014. The pair of oversized glasses with distorted lenses are one of three stations in the exhibit designed to bring to life some of the most common symptoms of MS, which may include mobility, vision, cognitive impairments and fatigue. MS occurs when the body's immune system attacks the central nervous system. (Gretchen Ertl/AP Images for Genzyme)

 

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8. Januvia (Diabetes)

Number of beneficiaries: 761,776

Number of claims: 4,358,783

Total drug cost (in billions): $1.46

Image: People pledge to set and attain their A1C (blood sugar) goals, or to help loved ones with type 2 diabetes do the same, at the America's Diabetes Challenge wall in front of the Flatiron Building, Wednesday, April 23, 2014, in New York. The wall is part of the America's Diabetes Challenge: Get to Your Goals educational program launched by Merck with award-winning actress S. Epatha Merkerson. (Jason DeCrow/AP Images for Merck)

 

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9. Lantus Solostar (Diabetes)

Number of beneficiaries: 862,887

Number of claims: 3,863,847

Total drug cost (in billions): $1.37

Image: Bottles of prescription medications move along a production line at Medco Health Solution, Inc.'s Willingboro Dispensing Pharmacy in this Feb. 28, 2006 file photo in Willingboro, N.J. (AP Photo/Mel Evans, file)

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10. Revlimid (Cancer)

Number of beneficiaries: 24,637

Number of claims: 153,782

Total drug cost (in billions): $1.35

Image: In this Sept. 5, 2011 photo, Wang Yuanjin, who suffers from acute myeloid leukemia, looks his X-ray image in his rented room near the hospital he visits in Shanghai, China. (AP Photo/Eugene Hoshiko)

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