Developing Medicare and Medicaid Substance Abuse Treatment Spending Estimates. D. Part D: Prescribed Drug Expenditures

09/28/2012

Expenditures for prescribed drugs can be estimated based on the CCW Part D Event file. Prescribed drug expenditures are categorized as core SA treatment services. The Part D Event file includes event records for both traditional Medicare FFS and MA enrollees, as well as the variable product service identification number, which provides the National Drug Code (NDC) of the prescribed drug. Table A.4 lists the NDC codes of pharmaceuticals used to treat SA. Only the first 8 digits of the 11-digit NDC code are used to identify the SA treatment pharmaceuticals. Event records listing these codes should be obtained. The values for the covered D plan paid amount and the non-covered plan paid amount are included in the Part D Event file. However, these values typically cannot be used for research. If they are available to this study then they should be summed to estimate payments under Part D. If they are not available national average payment amounts can be used to value the utilization observed in the Part D Event file.

TABLE 1. MA Enrollment 2007-2011
State 2007 2008 2009 2010 2011 Annual %
  Increase 2007-2011  
Alabama 115,569 148,889 170,475 176,216 174,202 10.8
Alaska 73 162 394 124 120 13.2
Arizona 263,637 266,647 279,833 331,444 342,978 6.8
Arkansas 38,567 51,037 60,177 71,654 75,645 18.3
California 1,449,282 1,412,343 1,547,064 1,663,441 1,734,900 4.6
Colorado 163,998 174,566 185,673 203,035 206,116 5.9
Connecticut 54,825 70,232 82,334 101,430 108,766 18.7
Delaware 3,140 4,276 5,074 4,882 5,149 13.2
District of Columbia   6,251 6,423 6,675 7,476 7,567 4.9
Florida 771,603 855,488 919,561 1,000,565 1,072,453 8.6
Georgia 94,412 126,626 153,374 250,725 269,574 30.0
Hawaii 68,224 71,525 75,142 84,418 88,986 6.9
Idaho 40,546 48,248 55,464 62,366 63,070 11.7
Illinois 136,851 153,977 167,047 168,636 163,256 4.5
Indiana 91,768 117,454 139,203 156,636 172,124 17.0
Iowa 55,755 56,579 61,156 64,737 64,749 3.8
Kansas 27,522 33,780 39,191 42,728 45,560 13.4
Kentucky 63,617 80,431 92,212 113,633 121,501 17.6
Louisiana 111,436 131,631 145,465 160,276 164,979 10.3
Maine 6,366 13,189 23,760 31,872 35,414 53.6
Maryland 37,104 42,526 49,058 60,424 61,840 13.6
Massachusetts 159,051 167,209 174,549 197,798 185,692 3.9
Michigan 237,200 334,732 383,595 255,650 389,983 13.2
Minnesota 206,593 216,208 237,035 321,109 349,715 14.1
Mississippi 31,003 38,503 42,584 44,821 46,676 10.8
Missouri 147,011 167,229 185,281 204,265 213,298 9.8
Montana 18,187 22,590 26,085 28,792 24,349 7.6
Nebraska 22,534 26,549 28,071 29,555 28,771 6.3
Nevada 93,213 98,477 102,090 106,276 109,757 4.2
New Hampshire 4,961 8,473 11,845 14,439 12,593 26.2
New Jersey 112,637 126,013 148,061 161,670 169,125 10.7
New Mexico 59,177 64,021 69,416 75,661 81,106 8.2
New York 674,029 746,644 802,917 885,826 918,606 8.0
North Carolina 190,081 219,180 241,331 257,240 262,974 8.5
North Dakota 6,247 7,225 7,458 7,789 9,472 11.0
Ohio 315,607 453,920 487,578 620,138 640,245 19.3
Oklahoma 66,441 74,625 81,765 88,723 89,678 7.8
Oregon 215,613 226,220 243,304 253,412 254,056 4.2
Pennsylvania 675,179 771,986 813,279 854,489 865,200 6.4
Rhode Island 59,740 60,309 60,713 62,751 63,553 1.6
South Carolina 56,316 75,797 89,143 118,221 123,989 21.8
South Dakota 4,863 7,162 8,504 9,623 11,663 24.4
Tennessee 170,217 193,201 211,865 251,137 265,842 11.8
Texas 373,014 440,729 492,428 569,606 600,193 12.6
Utah 45,406 60,705 71,429 83,301 88,115 18.0
Vermont 1,522 2,644 3,362 4,107 5,407 37.3
Virginia 95,991 121,193 141,101 155,855 155,941 12.9
Washington 170,145 190,271 209,878 237,487 247,229 9.8
West Virginia 60,515 66,944 72,009 71,267 73,222 4.9
Wisconsin 174,345 202,829 230,406 261,377 273,527 11.9
Wyoming 2,000 2,515 2,964 4,037 3,360   13.8  
United States   8,049,384     9,060,132     9,938,378     10,993,140     11,542,286   9.4

TABLE 2. MA Enrollment as a Share of Overall Medicare Enrollment, 2011
State   Medicare Beneficiaries     MA Enrollees     MA Share (%)  
Alabama 852,740 174,202 20.4
Alaska 65,356 120 0.2
Arizona 933,435 342,978 36.7
Arkansas 536,817 75,645 14.1
California 4,806,469 1,734,900 36.1
Colorado 631,387 206,116 32.6
Connecticut 571,020 108,766 19.0
Delaware 151,077 5,149 3.4
District of Columbia   78,860 7,567 9.6
Florida 3,390,801 1,072,453 31.6
Georgia 1,256,047 269,574 21.5
Hawaii 210,009 88,986 42.4
Idaho 232,471 63,070 27.1
Illinois 1,854,402 163,256 8.8
Indiana 1,014,432 172,124 17.0
Iowa 519,726 64,749 12.5
Kansas 435,802 45,560 10.5
Kentucky 767,801 121,501 15.8
Louisiana 692,718 164,979 23.8
Maine 267,012 35,414 13.3
Maryland 794,039 61,840 7.8
Massachusetts 1,067,929 185,692 17.4
Michigan 1,669,386 389,983 23.4
Minnesota 791,566 349,715 44.2
Mississippi 501,142 46,676 9.3
Missouri 1,009,613 213,298 21.1
Montana 171,499 24,349 14.2
Nebraska 280,441 28,771 10.3
Nevada 359,968 109,757 30.5
New Hampshire 221,168 12,593 5.7
New Jersey 1,336,988 169,125 12.6
New Mexico 316,973 81,106 25.6
New York 3,009,756 918,606 30.5
North Carolina 1,505,942 262,974 17.5
North Dakota 108,878 9,472 8.7
Ohio 1,909,462 640,245 33.5
Oklahoma 607,465 89,678 14.8
Oregon 625,594 254,056 40.6
Pennsylvania 2,290,509 865,200 37.8
Rhode Island 183,433 63,553 34.6
South Carolina 783,904 123,989 15.8
South Dakota 137,314 11,663 8.5
Tennessee 1,067,534 265,842 24.9
Texas 3,044,936 600,193 19.7
Utah 286,630 88,115 30.7
Vermont 112,831 5,407 4.8
Virginia 1,155,428 155,941 13.5
Washington 983,167 247,229 25.1
West Virginia 383,035 73,222 19.1
Wisconsin 918,344 273,527 29.8
Wyoming 80,994 3,360 4.1
United States 47,672,971 11,542,286 24.2

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