Healthcare/Long-Term Care Financing

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Appendix B. Development of Mcbs and Meps Estimates for This Report

This report uses 1996 Medicare Current Beneficiary Survey (MCBS) data to estimate prescription drug coverage, utilization, and spending for Medicare beneficiaries. 1996 Medical Expenditure Panel Survey (MEPS) data are used to provide estimates for the non-Medicare population. The MEPS surveyed a sample of the US civilian, noninstitutionalized popu

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Endnotes

1 - The true expenditure levels may be higher than this figure considering the possibility of under-reporting of prescription drug use in consumer surveys.

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Abstracts

The articles abstracted below represent some of the best sources of material found during the course of this study. The source of the abstract is listed at the end of each study summary. If no source is listed, it is the authors’ original abstract. American Association of Retired Persons (1997) Profile of Older Americans

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Bibliography

American Association of Retired Persons (1997) Profile of Older Americans . Angus D. Karpetz H. (1998) Pharmaceutical Policies in Canada. Pharmacoeconomics . 14 (Suppl. 1): 81-96. Anis A. Wen Q. (1998) Price Regulation of Pharmaceuticals in Canada. Journal of Health Economics . 17:21-38. Anon. (1999) Mail Order Drug Sales Leap 10 Percen

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.6 Conclusion

Comparisons of prescription drug prices between the United States and other developed countries generally show that prices are higher here. That said, we end where we began with four major questions: (1) How much higher are drug prices in the US? (2) For which drug products are the differences the greatest? (3) Why are drug prices lower elsewhere?

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.5.4 United Kingdom

The United Kingdom uses a variety of different methods to control drug costs. The primary method is through regulation of manufacturer profits. The Pharmaceutical Price Regulation Scheme (PPRS) regulates the rate of return on capital attributable to pharmaceutical sales in Britain. The government and the Association of the British Pharmaceutical I

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.5.3 France

Compared to other members of the OECD, the French pharmaceutical market is characterized by low prices complemented by high demand (Le Pen 1996). Pharmaceutical firms are free to set prices for all drugs not covered by the National Insurance plan, the Sécurité Sociale. The pricing committee, Comité Économique du Médicament (CEM) sets prices o

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.5.2 Germany

Over the past decade, the German government has introduced a number of substantial health care reforms affecting the sales of pharmaceuticals. Germany uses a combination of cost control mechanisms to manage its national drug budget. Both negative and positive “Lists of Reimbursable Drugs” (comparable to open and closed formularies) are used in

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.5.1 Canada

In Canada, the provinces have responsibility for assuring their citizens access to health care under a Federal mandate that establishes general eligibility and benefit standards. All provinces provide some level of prescription coverage for the elderly and social assistance recipients. Coverage for the remainder of the population varies by provinc

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.5 Country Specific Cost Control Approaches

The following sections present more detailed discussion of the drug cost control mechanisms used in Canada, Germany, France, and the UK.

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.4 Pharmaceutical Price Regulation

The OECD countries use a variety of pharmaceutical cost control approaches. The most common tactic in Germany is reference pricing, while France and Canada utilize product price controls and the UK uses profit regulation (Bloom and van Reenen, OECD, 1999; Dickson 1992). The most direct method of controlling drug costs is product price control wher

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.3 Cross-national Pharmaceutical Expenditures

From the perspective of public policy, the fact that drug prices vary across international boundaries is not as important as the cause of the differences. There are many other factors that can potentially contribute to cross-national price differences. These include national wealth, health insurance coverage of prescription medicine, the demograph

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.2 Studies of International Differences in Drug Prices

The US General Accounting Office (GAO) conducted one of the first widely cited studies of international price differences in prescription drugs in1992 (GAO 1992). The study compared 200 frequently prescribed drugs in the US and Canada sold by the same manufacturer in both countries. These drugs represented 54 percent of all prescriptions dispensed

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 4.1 Making Sound International Price Comparisons

Although the literature appears to support the hypothesis that American drug prices are higher than prices in other countries, special care must be taken when making cross-national price comparisons. A recent article by Danzon and Kim (1998) found that cross-national study results are highly sensitive to methodological choices. These choices inclu

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Section 4. International Drug Prices and Spending

“Why are American drug prices higher when compared to other countries?" Over the years, this has been a topic of much debate and study. Numerous studies have made drug price comparisons between the United States and other countries. Many of these are simply anecdotal reports appearing in the lay media. However, other more sophisticated analyses

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 3.3 Drug Pricing

The pricing for prescription drugs is complex and varies greatly depending on who is the payer and who is the seller. The following is a summary of three major measures of prescription prices: the Producer Price Index, the Average Wholesale Price and the retail pharmacy charge.

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 3.2 Drug Distribution Chain

Providing prescription drugs to patients involves an intricate, multifaceted system of drug distribution that includes a number of players such as pharmaceutical manufacturers, wholesalers, retailers, third-party administrators, pharmacy benefit management companies, managed care organizations, and providers. Each of these players participates in

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 3.1 National Trends in Drug Spending

While prescription drugs represent only about seven percent of total national health expenditures, in absolute dollars the market is formidable (Copeland, 1999). In 1998, the prescription drug market represented over $91 billion for approximately 2.5 billion prescriptions at the retail level. The average prescription cost increased 11.9 percent ov

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Section 3.

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. 2.6 What We Know and Need to Know

This section reviews what is known as well as that which remains unanswered in the context of the bolded questions presented throughout the discussion above. There are some common themes. The first crosscutting theme is that the literature focuses on drug use and spending almost as if “prescription drugs” were a single homogeneous product. A f

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