What do states pay?  Explore the CMS State Utilization Database

Once a quarter, the Centers for Medicare and Medicaid Services (CMS) publishes detailed Medicaid spending data down to the National Drug Code (NDC) level through what’s known as the State Utilization Database.  On its own, it’s somewhat challenging to use due to poor drug naming conventions and the lack of any reference pricing.  However, when merged with CMS's National Average Drug Acquisition Cost (NADAC) database, it comes to life! With this viz (a.k.a visualization), you can see the average invoice prices pharmacies pay for every medication, and then compare it to what the state is being charged.  Have fun exploring the madness that is Medicaid drug pricing.

Please note, this viz uses and displays the exact same data as our original Medicaid Drug Pricing Heat Map, just in a “HexMap” format. If you would rather see the original Heat Map, click here to navigate back to it.

Data Sources

How we Created our Dataset

  1. 46brooklyn's visualization tool of choice = Tableau Prep

  2. Lag effect NADAC prices - generic drugs only (NADAC is reported on roughly a one-month lag for generic drugs)

  3. Aggregate weekly NADAC into quarterly NADAC

  4. Join State Utilization Database and lagged quarterly NADAC on NDC and Year-Quarter

Want to build this database yourself? Check out the video below for a step-by-step tutorial:

How to Use   

  1. Choose year and quarter

  2. Filter drug list to brands or generics

  3. Choose the program type – Managed Care or Fee for Service

  4. Choose your drug

  5. Hover over any state to see the time series of what was paid versus its NADAC

NOTE: Drug list filtered to pills and tablets to avoid potential unit mismatches between databases. 

v 1.21 - posted December 30, 2020
For full release notes click here