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Medicare Payments for  Brand-Name Neurology Meds Soaring

From 2013 to 2017, number of claims increased 7.6 percent, but total payments increased 50.4 percent

WEDNESDAY, March 10, 2021 (HealthDay News) — From 2013 to 2017, there was an increase in payments for medications prescribed to individuals with neurologic conditions, especially for brand-name medications, according to a study published online March 10 in Neurology.

Adam de Havenon, M.D., from the University of Utah in Salt Lake City, and colleagues conducted a retrospective analysis of prescription claims in the Medicare Part D Prescriber Public Use Files from 2013 to 2017. In 2013, drugs were designated as generic (GEN), brand name only (BNO), and brand name prescribed even though a generic equivalent is available (BNGE).

Five hundred twenty drugs were included — 322 GEN, 61 BNO, and 137 BNGE — which represented 90,716,536 claims and resulted in payments of $26,654,750,720. The researchers found that from 2013 to 2017, the number of claims increased 7.6 percent, but the total payments increased 50.4 percent. Claim payments for GEN drugs increased 0.6 percent after adjustment for inflation, while significant increases of 42.4 and 45.9 percent were seen for BNO and BNGE drugs, respectively. The percentage of overall GEN and BNO claims increased from 81.9 to 88.0 percent and from 4.9 to 6.2 percent, respectively, while there was a decrease in BNGE claims from 13.3 to 5.8 percent. More than 50 percent of the total payments were for neuroimmunology/multiple sclerosis drugs, despite accounting for only 4.3 percent of claims.

“Our study shows a dramatic increase in the prices of neurologic medications over five years and the increase remained large even after being [adjusted] for inflation,” de Havenon said in a statement.

Several authors disclosed financial ties to industry, including pharmaceutical and medical device companies; one author disclosed medical/legal consulting.

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