Newly released CMS drug pricing data reveals continued generic drug pricing distortions

Newly released CMS drug pricing data reveals continued generic drug pricing distortions

Last week, we were met with a delightful surprise as we were perusing through the CMS website and discovered an out-of-the-blue drug pricing data update just begging to be downloaded. The hidden treasure was the freshly-updated CMS State Utilization database, which provides quarterly drug pricing data that shows what state Medicaid programs are spending on prescription drugs, providing an excellent window into the price-setting practices of the prescription drug supply chain. This most recent CMS data update ended up filling in most of the Q3 2018 divots and extended the 2018 data to include large portions of the fourth quarter. We have updated all of our dashboards that rely on this dataset, rolling all of them forward to Q4 2018. We couldn't resist sneaking an extended peak at the data, and while we will offer more in-depth analyses soon, we wanted to give some of our initial takeaways.

What’s happening to generic drug prices? April 2019 NADAC Survey Update

What’s happening to generic drug prices? April 2019 NADAC Survey Update

It’s NADAC survey results week, which means it’s time for our next installment of “what happened to generic drug prices last month.” It looks like we saw a lot of price decreases this past month, and and overall decrease in annualized spending. As always, the details matter, and we’re here to provide them for you. Check out our latest drug pricing report for a lot of important updates, plus an updated and upgraded NADAC Packed Bubble Chart!

New Ohio drug pricing data from shows where PBMs and pharmacies make their money

New Ohio drug pricing data from shows where PBMs and pharmacies make their money

For the first time in our existence, CMS has released drug pricing data that overlaps with the date of our launch. As we ripped open the data and examined CMS’ gift, we found some major changes in the way that the state of Ohio reported their data – and it has revealed some eye-opening information about PBM and pharmacy margins on prescription drugs. Given all the drug pricing noise out of Ohio, and the federal heat on PBM “spread pricing,” we decided to do a deep dive into what’s happening in Ohio, and how its new data provides incredible clues to determine where the money flows within the drug supply chain.

New CMS Medicaid drug pricing data released with stunning findings

New CMS Medicaid drug pricing data released with stunning findings

Recently, CMS updated their State Utilization databases, which provides quarterly drug pricing data that shows what state Medicaid programs are spending on prescription drugs. While Medicaid is only one (large) component of prescription drug spending, its importance is less based upon its size than it is the amazing amount of transparency in the program, relative to other segments of the market. This most recent CMS data update ended up filling in most of the Q2 2018 potholes and extended the 2018 data to include large portions of the third quarter. We have updated all of our dashboards that rely on this dataset, rolling all of them forward to Q3 2018, and there are some stunning takeaways.

What’s happening to generic drug prices? March 2019 NADAC Survey Update

What’s happening to generic drug prices? March 2019 NADAC Survey Update

It’s NADAC survey results week, which means it’s time for our next installment of “what happened to generic drug prices last month.” It looks like we saw a lot of price increases this past month, but overall decrease in annualized spending. As always, the details matter, and we’re here to provide them for you. Check out our latest drug pricing report for a lot of important updates, plus an updated and upgraded NADAC Packed Bubble Chart!

It's time to dig into Medicare Part D drug prices

It's time to dig into Medicare Part D drug prices

Over the last nine months we have sliced and diced generic drug pricing within Medicaid managed care to arrive at the conclusion that generic prices in Medicaid are subject to wild and seemingly arbitrary distortions. But the million dollar (or should we say $2 billion dollar) question is whether this problem is isolated to Medicaid, or if it is a broader issue plaguing Medicare Part D and Commercial plans as well? We now attempt to bring data into the fold to help answer this question. In this report, we embark on an in depth investigation into the pricing of the top 15 generic drugs in Medicare Part D - drugs that represented roughly a third of overall Part D generic spending in 2017. It turns out that the same arbitrary generic pricing behavior we have observed in Medicaid is alive and well within Part D.

Brand drug list prices remain largely in check so far in 2019

Brand drug list prices remain largely in check so far in 2019

With two months of solid data so far in 2019, according to CMS data, brand drug list prices appear to be largely under control when compared to previous years. While the data does not reflect true net costs, these are noteworthy trends regardless, and signs of the erosion of the much-maligned drug pricing “gross-to-net-bubble.” Check out this update for a breakdown of the price increases, as well as an update on the peculiar case of generic Prilosec spending.

What’s happening to generic drug prices? February 2019 NADAC Survey Update

What’s happening to generic drug prices? February 2019 NADAC Survey Update

It’s NADAC survey results week, which means it’s time for our next installment of “what happened to generic drug prices last month.” It looks like we saw some very unfortunate generic inflation this past month. As always, the details matter, and we’re here to provide them for you. Check out our latest drug pricing report for a lot of important updates, plus an updated and upgraded NADAC Packed Bubble Chart!

New dashboard launched to examine Medicaid markup galaxies

New dashboard launched to examine Medicaid markup galaxies

Looking to drill deeper into a state’s markup universe? Then our newest viz is for you. Medicaid Markup Galaxies separates each universe into three different groups (or celestially-speaking, “galaxies”). We call them the High-Cost, In-Range, and Low-Cost galaxies. The goal in doing so is to better quantify the nature of generic pricing distortions within state Medicaid programs. Additionally in today’s update, we put a bow on January’s brand drug price increases. See how 2019 is shaping up.

What’s happening to generic drug prices? January 2019 NADAC Survey Update

What’s happening to generic drug prices? January 2019 NADAC Survey Update

It’s NADAC survey results week, which means it’s time for our next installment of “what happened to generic drug prices last month.” On a positive note, it looks like there was a substantial amount of generic deflation in the aggregate. As always, the details matter, and we’re here to provide them for you. Check out our latest drug pricing report for a lot of important updates, plus an updated and upgraded NADAC Packed Bubble Chart!

New dashboard launched to track brand-drug price changes

New dashboard launched to track brand-drug price changes

The start of each new year brings a lot of “new-ness,” including a new round of price increases on brand-name drugs. This year has been no exception, and the media has been all over the subject. Unfortunately, we’ve found it difficult to figure out the “so what?” behind all of these price increases. On one hand, we are being told that the pharmaceutical manufacturers are back to “business as usual,” while on the other we are being told that the number of price increases are down meaningfully from last year. Which one is it? This felt like an opportunity to inject a healthy dose of facts into this discussion. So we set out to build a dashboard, 46brooklyn’s Brand Drug Price Change Box Score, that lets you visualize all brand-name manufacturer list price changes that are publicly-reported each week, drill down to the manufacturer and drug level, strength level, and compare and contrast different periods.

Slicing up the Pie: New dashboard launched to track drugmaker market share

Slicing up the Pie: New dashboard launched to track drugmaker market share

If you’re trying to discover reasons for why drug prices go up or down, one of the best things to look at is supply and demand. A new federal antitrust lawsuit alleges that several generic drugmakers were colluding in an effort to protect market share and raise prices. To get a better sense of what was happening in the market at the time the alleged collusion took place, it helps to track a drug’s market share over time. Using Medicaid utilization data and other public datasets, we have now launched a new dashboard to provide a crumb trail for those looking to determine the market distribution of drug manufacturers as prices fluctuate.

What’s happening to generic drug prices? December 2018 NADAC Survey Update

What’s happening to generic drug prices? December 2018 NADAC Survey Update

It’s NADAC survey results week, which means it’s time for our fifth installment of “what happened to generic drug prices last month.” On a positive note, it looks like there was a bit of net deflation. But overall it was a less than stellar month for generic deflation - it was the first month (since we started this monthly review) where we saw more generic drug price increases then decreases. As always, the details matter, and we’re here to provide them for you. Check out our latest drug pricing report for a lot of important updates, plus an updated NADAC Packed Bubble Chart!

Does Pennsylvania have a spread pricing problem?

Does Pennsylvania have a spread pricing problem?

As drug pricing scrutiny grows, PBM spread pricing of cheap, generic drugs is becoming a hot topic of conversation in states across the country. After the state of Ohio opened the books thanks to an audit from the state auditor, the uncovered $224 million PBM spread now has other states scrambling to see what they are being charged as well. One of those states is Pennsylvania, where their state auditor is trying hard to get the data he needs to see where the money is going in the third largest managed care program in the country. Since there are many folks wondering what’s going on in Pennsylvania, considering the current lack of hard data, we decided to dig into the publicly available data to see if Pennsylvania appears to have the makings of an “Ohio problem.”

What's happening to generic drug prices? November 2018 NADAC Survey update

What's happening to generic drug prices? November 2018 NADAC Survey update

CMS published their latest National Average Drug Acquisition Cost (NADAC) survey results today, and they've given us a lot to be thankful for! Applying the latest pricing changes to Medicaid's 2018 drug utilization mix results in $169 million of annualized savings on generic drugs. Moreover, we got both better "quantity" and "quality" out of this update.  In other words, more generic drugs went down in price (quantity) and of the ones that went down, a lot more went down by a meaningful amount (quality).

Inside AWP: The arbitrary pricing benchmark used to pay for generic drugs

Inside AWP: The arbitrary pricing benchmark used to pay for generic drugs

Average Wholesale Price (AWP) is a meaningless benchmark price for generic drugs, but despite its lack of substance, AWP-based payment models just won't go away.  Unfortunately the contractual reliance on a benchmark that has no relevance to actual price makes it very difficult for the payer to know if they are getting a good deal or not.  They are left to pay a fixed discount off of an unknown combination of meaningless, non-market-based, numbers. Seems like that would be tough sell, but this is drug pricing we are talking about, so of course, it's the norm. For the past couple months, we compiled data to create a visualization to help illustrate the problem that arises by anchoring generic drug costs to AWP. The finished product is embedded in this latest report "Inside AWP: The Arbitrary Pricing Benchmark Used to Pay for Prescription Drugs," along with our observations and analysis.

All 46brooklyn Visualizations Updated to include newly-released Q2 2018 State Utilization Data

All 46brooklyn Visualizations  Updated to include newly-released Q2 2018 State Utilization Data

On October 24, 2018, CMS released an update to all State Utilization Data posted on data.medicaid.gov. Most notably, the 2018 database was rolled forward to include Q2 2018 data. As such, we have released updates to all 46brooklyn dashboards posted on our visualizations page. In conjunction with this update, we have also published a new dashboard that allows the user to identify the top 20 drugs in each state’s managed care (MCO) program that have a markup (MCO paid amount less NADAC ingredient cost) of over $20 per prescription.

What’s happening to generic drug prices? October 2018 NADAC Survey Update

What’s happening to generic drug prices? October 2018 NADAC Survey Update

It’s NADAC survey results week, which means it’s time for our third installment of “what happened to generic drug prices last month.” It looks like there was a bit of net deflation, but overall, there were an equal number of price increases and decreases. But as always, the details matter. Check out our latest drug pricing report for a lot of important updates, plus an updated NADAC Packed Bubble Chart!

New visualization tool examines the wild universe of prescription drug price markups

New visualization tool examines the wild universe of prescription drug price markups

After Bloomberg put drug price markups on the map, we decided a deeper dive into markups was warranted to see which drugs were getting overinflated and which drugs were not. To sort things out, we built a new visualization dashboard to compare drug markups between state Medicaid programs. We call our creation the “Medicaid Markup Universe.” In this new visualization tool, we found a disturbingly large difference in drug markups across generic drugs in state Medicaid managed care programs, resulting in a slew of warped incentives that pressure supply chain members to value certain medications over others, and thus, certain patients over others. Check out our newest visualization tool and read our latest drug pricing report.

What's happening to generic drug prices? - September 2018 NADAC Survey Update

What's happening to generic drug prices? - September 2018 NADAC Survey Update

It’s NADAC survey results week, which means it’s time for our second installment of “what happened to generic drug prices last month.” Good news. Prices are dropping significantly. Check out our latest drug pricing report for lots of important updates, plus an updated NADAC Packed Bubble Chart!