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Medicaid prescription drug spending in the 1990s: a decade of change.

Baugh DK, Pine PL, Blackwell S, Ciborowski G - Health Care Financ Rev (2004)

Bottom Line: From 1990 to 2000, Medicaid drug spending increased from $4.4 billion to over $20 billion, an average annual increase of 16.3 percent.Disabled persons experienced an even greater 20 percent average annual increase.By drug category in 1997 (for 29 States), the highest spending amount was for central nervous system (CNS) drugs, accounting for 17 percent of total Medicaid drug spending.

View Article: PubMed Central - PubMed

Affiliation: Centers for Medicare & Medicaid Services, 7500 Security Boulevard, C3-20-17, Baltimore, MD 21244, USA. dbaugh@cms.hhs.gov

ABSTRACT
Medicaid spending increased dramatically during the 1990s, driven in part by spending for prescription drugs. From 1990 to 2000, Medicaid drug spending increased from $4.4 billion to over $20 billion, an average annual increase of 16.3 percent. Disabled persons experienced an even greater 20 percent average annual increase. By drug category in 1997 (for 29 States), the highest spending amount was for central nervous system (CNS) drugs, accounting for 17 percent of total Medicaid drug spending. These findings provide information on drug spending for dually eligible beneficiaries to policymakers as they seek to target cost-effective coverage and drug therapies.

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Medicaid Prescription Drug Payments1 as a Percent of Total Medicaid Payments, by Eligibility Group2: Federal FYs 1990-20001 Medicaid prescription drug payments are gross amounts prior to the receipt of rebates to the States by prescription drug manufacturers. Medicaid prescription drug payments include all payments for prescription drugs provided under an FFS setting (i.e., prescription drugs for which Medicaid paid a pharmacy claim). Since Medicaid pays a single premium to a prepaid plan for all covered services, it is not possible to identify prescription drug payments when they are covered by a prepaid plan. To this extent, Medicaid prescription drug payments, presented here, may understate total Medicaid payments for prescription drugs. Data are reported for the 50 States and the District of Columbia and exclude other Medicaid jurisdictions. Although Hawaii did not report for 2000, their 1999 data were used as an estimate for 2000.2 The Medicaid eligibility group identifies the basis on which Medicaid eligibility was determined, regardless of cash assistance status. The blind/disabled group includes individuals of any age who were determined to be eligible because of disability. The children's group includes foster care children. The all group includes a small number of individuals that are not reported in the other four groups.SOURCE: Centers for Medicare & Medicaid Services: Data from CMS Form-2082 and the Medicaid Statistical Information System, 1990-2000.
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f3-hcfr-25-3-005: Medicaid Prescription Drug Payments1 as a Percent of Total Medicaid Payments, by Eligibility Group2: Federal FYs 1990-20001 Medicaid prescription drug payments are gross amounts prior to the receipt of rebates to the States by prescription drug manufacturers. Medicaid prescription drug payments include all payments for prescription drugs provided under an FFS setting (i.e., prescription drugs for which Medicaid paid a pharmacy claim). Since Medicaid pays a single premium to a prepaid plan for all covered services, it is not possible to identify prescription drug payments when they are covered by a prepaid plan. To this extent, Medicaid prescription drug payments, presented here, may understate total Medicaid payments for prescription drugs. Data are reported for the 50 States and the District of Columbia and exclude other Medicaid jurisdictions. Although Hawaii did not report for 2000, their 1999 data were used as an estimate for 2000.2 The Medicaid eligibility group identifies the basis on which Medicaid eligibility was determined, regardless of cash assistance status. The blind/disabled group includes individuals of any age who were determined to be eligible because of disability. The children's group includes foster care children. The all group includes a small number of individuals that are not reported in the other four groups.SOURCE: Centers for Medicare & Medicaid Services: Data from CMS Form-2082 and the Medicaid Statistical Information System, 1990-2000.

Mentions: Figure 3 shows Medicaid prescription drug payments as a percent of total Medicaid payments during the decade. For all beneficiaries, prescription drug payments increased from 6.8 percent (1990) to 11.9 percent (2000) of total payments. Similarly, drug payments increased from 7.0 to 12.0 percent of total payments for the aged over these years. Drug payments for the disabled rose from 7.6 percent (1990) to 15.9 percent (2000) of total payments. The increase for adults was less dramatic. In 1990, drug payments represented 6.7 percent of total Medicaid spending for adults and, by 2000, drug payments rose to 8.1 percent of total payments for adults. From 1990 to 1996, prescription drugs were a steadily increasing percent of total Medicaid spending for children. However, there were intermittent increases and decreases after 1996. This finding may reflect the fact that many Medicaid children were being enrolled in prepaid plans in the late 1990s.


Medicaid prescription drug spending in the 1990s: a decade of change.

Baugh DK, Pine PL, Blackwell S, Ciborowski G - Health Care Financ Rev (2004)

Medicaid Prescription Drug Payments1 as a Percent of Total Medicaid Payments, by Eligibility Group2: Federal FYs 1990-20001 Medicaid prescription drug payments are gross amounts prior to the receipt of rebates to the States by prescription drug manufacturers. Medicaid prescription drug payments include all payments for prescription drugs provided under an FFS setting (i.e., prescription drugs for which Medicaid paid a pharmacy claim). Since Medicaid pays a single premium to a prepaid plan for all covered services, it is not possible to identify prescription drug payments when they are covered by a prepaid plan. To this extent, Medicaid prescription drug payments, presented here, may understate total Medicaid payments for prescription drugs. Data are reported for the 50 States and the District of Columbia and exclude other Medicaid jurisdictions. Although Hawaii did not report for 2000, their 1999 data were used as an estimate for 2000.2 The Medicaid eligibility group identifies the basis on which Medicaid eligibility was determined, regardless of cash assistance status. The blind/disabled group includes individuals of any age who were determined to be eligible because of disability. The children's group includes foster care children. The all group includes a small number of individuals that are not reported in the other four groups.SOURCE: Centers for Medicare & Medicaid Services: Data from CMS Form-2082 and the Medicaid Statistical Information System, 1990-2000.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194863&req=5

f3-hcfr-25-3-005: Medicaid Prescription Drug Payments1 as a Percent of Total Medicaid Payments, by Eligibility Group2: Federal FYs 1990-20001 Medicaid prescription drug payments are gross amounts prior to the receipt of rebates to the States by prescription drug manufacturers. Medicaid prescription drug payments include all payments for prescription drugs provided under an FFS setting (i.e., prescription drugs for which Medicaid paid a pharmacy claim). Since Medicaid pays a single premium to a prepaid plan for all covered services, it is not possible to identify prescription drug payments when they are covered by a prepaid plan. To this extent, Medicaid prescription drug payments, presented here, may understate total Medicaid payments for prescription drugs. Data are reported for the 50 States and the District of Columbia and exclude other Medicaid jurisdictions. Although Hawaii did not report for 2000, their 1999 data were used as an estimate for 2000.2 The Medicaid eligibility group identifies the basis on which Medicaid eligibility was determined, regardless of cash assistance status. The blind/disabled group includes individuals of any age who were determined to be eligible because of disability. The children's group includes foster care children. The all group includes a small number of individuals that are not reported in the other four groups.SOURCE: Centers for Medicare & Medicaid Services: Data from CMS Form-2082 and the Medicaid Statistical Information System, 1990-2000.
Mentions: Figure 3 shows Medicaid prescription drug payments as a percent of total Medicaid payments during the decade. For all beneficiaries, prescription drug payments increased from 6.8 percent (1990) to 11.9 percent (2000) of total payments. Similarly, drug payments increased from 7.0 to 12.0 percent of total payments for the aged over these years. Drug payments for the disabled rose from 7.6 percent (1990) to 15.9 percent (2000) of total payments. The increase for adults was less dramatic. In 1990, drug payments represented 6.7 percent of total Medicaid spending for adults and, by 2000, drug payments rose to 8.1 percent of total payments for adults. From 1990 to 1996, prescription drugs were a steadily increasing percent of total Medicaid spending for children. However, there were intermittent increases and decreases after 1996. This finding may reflect the fact that many Medicaid children were being enrolled in prepaid plans in the late 1990s.

Bottom Line: From 1990 to 2000, Medicaid drug spending increased from $4.4 billion to over $20 billion, an average annual increase of 16.3 percent.Disabled persons experienced an even greater 20 percent average annual increase.By drug category in 1997 (for 29 States), the highest spending amount was for central nervous system (CNS) drugs, accounting for 17 percent of total Medicaid drug spending.

View Article: PubMed Central - PubMed

Affiliation: Centers for Medicare & Medicaid Services, 7500 Security Boulevard, C3-20-17, Baltimore, MD 21244, USA. dbaugh@cms.hhs.gov

ABSTRACT
Medicaid spending increased dramatically during the 1990s, driven in part by spending for prescription drugs. From 1990 to 2000, Medicaid drug spending increased from $4.4 billion to over $20 billion, an average annual increase of 16.3 percent. Disabled persons experienced an even greater 20 percent average annual increase. By drug category in 1997 (for 29 States), the highest spending amount was for central nervous system (CNS) drugs, accounting for 17 percent of total Medicaid drug spending. These findings provide information on drug spending for dually eligible beneficiaries to policymakers as they seek to target cost-effective coverage and drug therapies.

Show MeSH