It’s the middle of July. A time of year for pool parties, barbecues, campfires. and generally sweating your butt off. It’s a relaxing time of year for the majority of us. But what about the ski bums out there? It’s a long six months (five if you are lucky) until the first big dump of the year. At 46brooklyn, we sympathize with people who are impatiently waiting for things – except rather than waiting to shred the gnar, we’ve been anxiously waiting to shred through Medicare Part D drug pricing data. Good news, drug pricing enthusiasts; we have a big (data) dump for you! After months of work on our newest drug pricing tool, we are pleased to release the new Medicare Part D Drug Pricing Ski Slope dashboard. In this viz, we give you the ability to select one of many drugs (brand and generic, oral solid and non-oral solid), and view the price set by thousands of Part D plans for your selected drug. For good measure, we added a line to show you the true market-based cost of the drug (based on NADAC), so you can see how frustratingly random Part D pricing is by different plans for the same drug. So get your balaclava on and join us as we traverse the Part D drug pricing slopes.
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.
Recently, CMS updated their State Utilization databases, which provides quarterly drug pricing data that shows what state Medicaid programs are spending on prescription drugs. This most recent 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 insightful takeaways. This update is a really big deal for us at 46brooklyn, because it is the first time that a dataset’s timing will overlap with our existence as an organization. With our launch in August 2018, this meant that CMS’ latest utilization data update for Q3 2018 would be the first real quarter of data that could have been theoretically impacted by our work and Ohio’s work to bring transparency to drug pricing in state Medicaid programs and beyond. After analyzing the data, the results are nothing short of amazing, and a clear indication that this system is in the midst of change. Here’s our insights.
Earlier this week, Bloomberg reporters published their results of a fascinating deep dive into Medicaid generic drug prices. The piece did an excellent job explaining the ins and outs of the hidden pricing spreads that exist on generic drugs, and it featured some intuitive visualizations that helped educate readers who may not have been familiar with these little-known drug price tactics. The analysis conducted by Bloomberg also integrated the results of a recent report from the state of Ohio's Auditor, which found that in a one-year span, PBMs pocketed more than $224 million dollars in spread pricing. Armed with this data, we set out to discover if we could deduce what pharmacy margins were over that same time period in an effort to peel back new layers of the onion and provide better information on where the money is going. Check out our newest drug pricing report to learn more about hidden prescription drug markups.
It is well-known that competition in the generic manufacturer marketplace drives drug prices down considerably. Plaquenil, a brand-name drug that has been on the market since 1955, eventually saw generics enter the market almost a quarter of a century ago. By all accounts, generic Plaquenil – known as hydroxychloroquine – had become a very affordable drug at approximately 10 cents per pill. But FDA actions quickly dried up the supply of the drug, causing prices to balloon more than 2,500%. This report examines how state Medicaid programs were impacted by this price spike, and how some states continued paying elevated rates even after the price came crashing back down.
Of all the drugs in the marketplace, few have been as much of a topic of conversation as Gleevec, a popular medication for cancer patients. While the brand manufacturer Novartis was frequently criticized for its price increases during its exclusivity period, when the generics entered the market, prices of those versions plummeted. But in analyzing CMS data, we found that even though prices were crashing, some state Medicaid programs were still being charged much higher prices.