To better understand the changes in price and quantity of sterile injectable drugs used in oncology treatment, ASPE created a dataset of average sales prices, Medicare Part B volume, and reported shortages of oncology sterile injectable drugs since January 2006. ASPE derived average sales prices from the Medicare Part B quarterly payment limits publicized on the CMS website and adjusted them to 2011 dollars using the CPI-U. Pharmaceutical manufacturers report prices to CMS quarterly, and must include all discounts and rebates to reflect actual market prices. CMS provided ASPE with Medicare Part B quarterly volume for the J9000-J9999 series of HCPCS codes, which includes most oncology sterile injectable drugs. The University of Utah provided ASPE with the dates of active and resolved drug shortages reported to the American Society of Health System Pharmacists. After creating this dataset, ASPE produced graphs of each drug showing average sales prices, Medicare Part B volume, and the timing of reported shortages. ASPE also calculated the average annual change in price and volume for each drug. For consistency in comparing changes across the 2006-2011 period, analysis is restricted to the J9000-J9999 series of HCPCS codes with greater than 100 services in Q1 2006 and an average of more than 1,000 services annually (n = 72). Our sample of oncology sterile injectable drugs in shortage (n = 44) as identified by the University of Utah is a subset of the 132 sterile injectable drug shortages reported by the FDA, which covers more drug classes than oncology drugs. However, the volume patterns are similar to those in the IMS data which includes the entire market of oncology sterile injectable drugs.
ASPE’s analysis of Medicare Part B volume shows that oncology sterile injectable drugs that experienced shortages since 2008 (n = 44) decreased in volume from 3.1 million units in Q1 2006 (average of 70,884 units per drug) to 3.0 million units in Q1 2011 (average of 68,743 units per drug). In contrast, oncology sterile injectable drugs that have not experienced shortages (n = 28) increased in volume from 21.2 million units in Q1 2006 (average of 756,320 units per drug) to 26.2 million units in Q1 2011 (average of 936,079 units per drug). Analysis of average sales prices shows that shows that oncology sterile injectable drugs that experienced shortages since 2008 decreased in price from $56.17 per unit in Q1 2006 to $37.88 per unit in Q1 2011. Oncology sterile injectable drugs that have not experienced shortages have had relatively stable prices over this period.