Article Figures & Data
Figures
- Figure 1.
Average unit price for existing and new drugs, unweighted (top) and weighted (bottom) by volume, for the North Carolina Medicaid program, 1998–2000. * Unweighted = (∑ unit price for each drug)/(number of drugs). † Weighted = (∑units dispensed for each drug)/( ∑ expenditures for each drug).
Tables
- Table 1.
Description of Enrollees, Visits, and Prescriptions in the North Carolina Medicaid Program, 1998–2000
Characteristics 1998 1999 2000 Enrollees No. 1,204,728 1,228,641 1,232,271 Age, mean (SD), years 29 (28)10 28 (28) 27 (27) Female, % 61 60 60 Race, % Black 50 48 46 Hispanic 2 3 4 White 38 40 42 Other 10 9 8 Average length of enrollment, years 0.76 0.76 0.80 Total person-years 915,873 931,810 986,260 Visits No. 1,959,412 1,968,187 1,866,831 Type, % New 7.4 6.6 6.1 Follow-up 88.5 89.5 89.8 Consultation 4.1 3.9 4.1 Complexity, % Minimally 3.8 3.4 3.2 Somewhat 20.5 19.7 17.8 Moderately 58.9 60.1 61.2 Highly 13.8 13.8 14.8 Extremely 3.1 2.9 3.0 Average No. of visits per person-year 2.1 2.1 1.9 Prescriptions No. 11,895,277 13,247,904 15,261,907 Expenditures, $ 460,748,584 575,379,831 748,432,849 Average prescription cost, $ 39 43 49 Average No. of prescriptions per person-year 13.0 14.2 15.5 Cost of prescription coverage per person-year, $ 503 617 759 - Table 2.
Expenditures and Frequency of Prescribing for the 15 Most Expensive Drugs in the North Carolina Medicaid Program, 1998–2000
Number of Units Dispensed per Person-year Generic Name Trade Name 2000 Expenditures, $ (in millions) Change in Expenditures 1998–2000, $ (in millions) Change in Expenditures as Percent of Total Increase 1998–2000 Cumulative Percent of Total Increase in Expenditures 1998–2000 1998 1999 2000 Omeprazole Prilosec 36.2 15.9 5.5 5.5 6.5 8.4 9.9 Olanzapine Zyprexa 28.4 15.4 5.3 10.8 2.4 3.8 4.6 Risperidone Risperdal 20.8 8.8 3.0 13.9 4.6 5.4 6.6 Lansoprazole Prevacid 20.4 14.8 5.1 19.0 1.9 3.6 5.9 Celecoxib Celebrex 13.0 13.0 4.5 23.6 0.0 1.9 7.0 Loratadine Claritin 12.4 6.0 2.1 25.6 3.5 4.8 5.8 Fluoxetine Prozac 11.3 3.2 1.1 26.8 3.8 4.2 4.6 Valproic acid Depakote 10.6 4.2 1.5 28.2 4.5 5.5 6.7 Amlodipine Norvasc 10.6 4.4 1.5 29.7 8.5 10.0 10.9 Paroxetine Paxil 10.1 3.7 1.3 31.0 3.5 4.1 4.5 Sertraline Zoloft 10.1 3.2 1.1 32.2 3.6 4.2 4.7 Ranitidine Zantac 9.8 −3.6 −1.3 30.9 1.4 2.8 4.4 Atorvastatin Lipitor 9.7 7.1 2.5 33.4 9.5 8.5 8.2 Gabapentin Neurontin 9.1 5.8 2.0 35.4 3.8 5.9 9.1 Metformin Glucophage 7.5 4.6 1.6 38.0 5.6 7.8 10.4
The Article in Brief
Spending on prescription drugs is increasing at high rates in the United States as a whole, and at even higher rates in state Medicaid programs. In the North Carolina Medicaid program in the years 1998-2000, the major cause of the increase in drug costs was a rise in the number of prescriptions for new and more expensive medications. There is an important role for many newer and more expensive drugs, but that role must be made more clear. To help control rising spending on prescription drugs, the costs and benefits of possible treatments must be considered.
