The Congressional Budget Office analyzed how changes in prescription drug use affect Medicare spending on medical services. It found that higher drug use leads to lower medical costs, as drugs help control diseases and reduce complications. The CBO reviewed studies on this "offset effect" and found that a 1% increase in drug use leads to a 0.2% decrease in other medical spending. As an example, the CBO estimated that closing the Medicare Part D coverage gap would increase drug use by 5% and lower medical costs by 1%, reducing the total cost of closing the gap.
Preventive medical services encompass a wide range of interventions, including vaccinations that prevent diseases from occurring and screening tests designed to detect the presence of a disease before symptoms appear. Delivering preventive medical services results in costs for each person using the service. Vaccinations may cause some of those people to avoid the targeted disease, and screenings may allow some people to receive treatment earlier. Those people generally benefit from preventive medical services, but the net result can be decreases or increases in overall health care spending.
In this presentation, CBO’s Director provides an overview of the agency’s methods for estimating the budgetary effects of proposals to expand the use of preventive medical services.
Presentation by Heidi Golding, an analyst in CBO’s National Security Division, at the Southern Economic Association Annual Meeting.
In this presentation, CBO provides background information on the VA health care system and past spending and describes 10-year projections by CBO on VA health spending under three different scenarios. CBO finds that, under certain assumptions, future spending required to treat veterans may be substantially higher (in inflation-adjusted dollars) than recent appropriations.
Preventive medical services encompass a wide range of interventions, including vaccinations that prevent diseases from occurring and screening tests designed to detect the presence of a disease before symptoms appear. Delivering preventive medical services results in costs for each person using the service. Vaccinations may cause some of those people to avoid the targeted disease, and screenings may allow some people to receive treatment earlier. Those people generally benefit from preventive medical services, but the net result can be decreases or increases in overall health care spending.
In this presentation, CBO’s Director provides an overview of the agency’s methods for estimating the budgetary effects of proposals to expand the use of preventive medical services.
Presentation by Heidi Golding, an analyst in CBO’s National Security Division, at the Southern Economic Association Annual Meeting.
In this presentation, CBO provides background information on the VA health care system and past spending and describes 10-year projections by CBO on VA health spending under three different scenarios. CBO finds that, under certain assumptions, future spending required to treat veterans may be substantially higher (in inflation-adjusted dollars) than recent appropriations.
Presentation by Tamara Hayford, Chief of CBO’s Health Policy Studies Unit, at the Association for Public Policy Analysis & Management 2021 Annual Research Meeting.
Presentation by Chapin White, CBO's Deputy Director of Health Analysis, to the Leadership Fellowship Program at the National Hispanic Medical Association.
Presentation by Kathleen Burke, John McClelland, and Jennifer Shand, analysts in CBO’s Tax Analysis Division, to the National Association of Legislative Fiscal Offices.
Presentation by Linda Bilheimer, CBO’s Assistant Director for Health, Retirement, And Long-Term Analysis, to the 2014 National Health Policy Conference
Presentation at the Fifth Biennial Conference of the American Society of Health Economists, by Allison Percy, Health, Retirement, and Long-Term Analysis Division
Presentation by Joyce Manchester, Chief, Long-Term Analysis Unit, to the Committee on the Long-Run Macro-Economic Effects of the Aging U.S. Population, National Academy of Sciences
Presentation by Alice Burns and Jaeger Nelson, analysts in CBO’s Budget Analysis Division and Macroeconomic Analysis Division, to the National Tax Association.
Presentation by Heidi Golding and Elizabeth Bass, analysts in CBO's National Security Division, at the Annual Conference of the Western Economic Association International.
Presentation by Tamara Hayford, Chief of CBO’s Health Policy Studies Unit, at the Association for Public Policy Analysis & Management 2021 Annual Research Meeting.
Presentation by Chapin White, CBO's Deputy Director of Health Analysis, to the Leadership Fellowship Program at the National Hispanic Medical Association.
Presentation by Kathleen Burke, John McClelland, and Jennifer Shand, analysts in CBO’s Tax Analysis Division, to the National Association of Legislative Fiscal Offices.
Presentation by Linda Bilheimer, CBO’s Assistant Director for Health, Retirement, And Long-Term Analysis, to the 2014 National Health Policy Conference
Presentation at the Fifth Biennial Conference of the American Society of Health Economists, by Allison Percy, Health, Retirement, and Long-Term Analysis Division
Presentation by Joyce Manchester, Chief, Long-Term Analysis Unit, to the Committee on the Long-Run Macro-Economic Effects of the Aging U.S. Population, National Academy of Sciences
Presentation by Alice Burns and Jaeger Nelson, analysts in CBO’s Budget Analysis Division and Macroeconomic Analysis Division, to the National Tax Association.
Presentation by Heidi Golding and Elizabeth Bass, analysts in CBO's National Security Division, at the Annual Conference of the Western Economic Association International.
BUSINESS83www.AHDBonline.com l American Health & Drug Ben.docxjasoninnes20
BUSINESS
83www.AHDBonline.com l American Health & Drug Benefits lVol 5, No 2 l March/April 2012
Rheumatoid arthritis (RA) is a chronic systemicautoimmune disorder and the most common formof inflammatory arthritis.1 RA affects 1% of the
population, most often adults aged 40 to 70 years.2
Recent epidemiologic data indicate that the incidence of
RA in women has risen in the past 10 years.3 Because RA
affects many individuals who are of working age and
remains a major cause of disability, the economic burden
of RA adds a significant cost not only to patients and
their families, but also to society as a whole.1,4 In addi-
tion, reduced quality of life, loss of work productivity,
and substantial healthcare utilization are factors that
must be considered in RA management.4,5
Because complications of RA may begin to develop
within months of disease onset, early and aggressive
treatment is considered clinically necessary to manage
immediate symptoms of pain associated with inflamma-
tion, but also to slow disease progression to prevent long-
term disability.1,6,7 Historically, estimates of work disabili-
Ms Greenapple is President, Reimbursement Intelligence,
LLC, Madison, NJ.
Trends in Biologic Therapies for
Rheumatoid Arthritis: Results from a
Survey of Payers and Providers
Rhonda Greenapple, MSPH
Background: Advances in therapies for rheumatoid arthritis (RA), particularly biologics,
have transformed the treatment paradigm for RA. However, the associated costs of these
therapies result in a significant economic burden on the healthcare system. As a chronic
disease requiring lifelong treatment, most health plans now position RA drugs as a high-
priority therapeutic category.
Objective: To identify provider and payer practices and perceptions regarding coverage
of RA biologics in the current marketplace, as well as emerging trends in reimbursement
practices.
Method: In November 2011, Reimbursement Intelligence, a healthcare research company,
collected and analyzed quantitative and qualitative data via parallel-structure online surveys
of 100 rheumatologists and 50 health plan payers (medical and pharmacy directors) who
represent more than 80 million covered lives. The surveys included approximately 150 ques-
tions, and the surveys were designed to force a response for each question.
Results: Payers reported using tier placement, prior authorization, and contracting in
determining coverage strategies for RA biologics. Among providers, experience with older
RA agents remains the key driver for the choice of a biologic agent. A majority of payers
and providers (68% and 54%, respectively) reported that they did not anticipate a change
in the way their plans would manage biologics over the next 2 to 4 years. Payers’ re -
sponses indicated uncertainty about how therapeutic positioning of newer, small-molecule
drugs at price parity to biologics would affect the current reimbursement landscape.
Survey responses show that approval of an indication f ...
Comparative assessment of stakeholder feedback capt-poster presentation-2019Naghmeh Foroutan
The present study was designed for obtaining Canadian pricing and reimbursement stakeholders’ opinion on a list of proposed recommendations for updating the 2007 Patented Medicine Prices Review Board (PMPRB) Budget Impact Analysis guidelines. Methods: Stakeholders from different perspectives including policymakers (public and private payers) and industry experts/consultants were invited to participate in the study (private payer and industry perspectives were not included in the PMPRB 2007 BIA guidelines). Using a mixed methods approach, an interview guide and a written survey were developed based on discordance between the PMPRB 2007 BIA guidelines recommendations and Canadian provincial, and other national or transnational BIA guidelines. A thematic content analysis was applied for the qualitative data analysis. Results: We conducted nine interviews with policymakers and twenty-seven surveys with industry experts/consultants. Most interviewees were positive about the usefulness of BIA in disinvestment decisions and believed that reviewing cost-effectiveness analysis (CEA) and BIA together, at the same time, could be particularly informative for setting value-based prices. Fifty-six percent of the proposed recommendations were approved (e.g., the use of post-market real-world data for assessing the reliability of BIAs first-year forecasts), whereas, 30% were not supported by stakeholders (e.g., indirect costs). Some recommendations will need further input from public and private payers before being included in a revised version of the PMPRB BIA guidelines (e.g., inclusion of cost offsets). Conclusions: In the present study, Canadian payers and manufacturers’ views on the BIA recommendations, obtained through qualitative and quantitative methods, provide additional insight to help define BIA guidelines from a Canadian perspective. This information may also be of value for updating or creating BIA guidelines worldwide.
This presentation describes the objectives, approach and application of Drug Utilization studies in Pharmacotherapeutics. This emphasizes on how to conduct a drug utilization studies.
A new study adds further evidence to suggest that opioid prescribing in the U.S. is skewed and concentrated among a few providers. Researchers looked at prescribing patterns in data from an unspecified national private insurer between 2003-2017.
Around 670,000 providers prescribed more than 8 million standard doses of opioid prescriptions — but more than a quarter of these prescriptions were written by only 1% of physicians. And in 2017, these physicians prescribed nearly half of all the dispensed opioids. This small group of doctors also prescribed higher doses than recommended, and for longer durations than guidelines allow.
What’s encouraging, the authors suggest, is that the vast majority of physicians do seem to follow guidelines. Some caveats: The study was based on one company’s data, and didn’t look at medical reasons behind prescriptions.
White Paper: Best Practices for Medical Benefit Management (MBM)Tai Freligh
Biologic, biotechnology-based, rare disease, or high-cost pharmaceuticals — collectively known as specialty drugs — can be covered under the pharmacy benefit, the medical benefit, or both depending on the benefit design plan sponsors require of the third-party administrator (including the pharmacy benefit manager – PBM; administrative service organization – ASO; or any administrator of a medical or pharmacy benefit).
On average, up to 50% of specialty drugs today are covered under the medical benefit.
With the exception of a few key therapy areas, traditional tools used to manage specialty drugs under the medical benefit, such as prior authorizations and medical benefit carve-outs (i.e., “white-bagging”), have yielded limited value to plan sponsors.
This thought leadership analysis, with insights from recognized industry experts, will provide an overview of the challenges.
Download the complete white paper to get the rest of the report, including a summary of the key issues plan sponsors must address and insights into best practices through an innovative new approach, Medical Benefit Drug Management (MBM).
Link: http://www.PharMedQuest.com/White-Paper
Presentation by Jared Jageler, David Adler, Noelia Duchovny, and Evan Herrnstadt, analysts in CBO’s Microeconomic Studies and Health Analysis Divisions, at the Association of Environmental and Resource Economists Summer Conference.
Presentation by Mark Hadley, CBO's Chief Operating Officer and General Counsel, at the 2nd NABO-OECD Annual Conference of Asian Parliamentary Budget Officials.
Presentation by Daria Pelech, an analyst in CBO’s Health Analysis Division, at the Center for Health Insurance Reform McCourt School of Public Policy, Georgetown University.
This slide deck highlights CBO’s key findings about the outlook for the economy as described in its new report, The Budget and Economic Outlook: 2024 to 2034.
Presentation by CBO analysts Rebecca Heller, Shannon Mok, and James Pearce, and Census Bureau research economist Jonathan Rothbaum at the American Economic Association Annual Meeting, Committee on Economic Statistics.
Presentation by Eric J. Labs, an analyst in CBO’s National Security Division, at the Bank of America 2024 Defense Outlook and Commercial Aerospace Forum.
Presentation by Elizabeth Ash, William Carrington, Rebecca Heller, and Grace Hwang of CBO’s Labor, Income Security, and Long-Term Analysis and Health Analysis divisions to the Children’s Health Group, American Academy of Pediatrics.
Presentation by Molly Dahl, Chief of CBO’s Long-Term Analysis Unit, at a meeting of the National Conference of State Legislatures’ Budget Working Group.
In the President’s 2024 budget request, total military compensation is $551 billion, including veterans' benefits. That amount represents an increase of 134 percent since 1999 after removing the effects of inflation.
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how to sell pi coins on Bitmart crypto exchangeDOT TECH
Yes. Pi network coins can be exchanged but not on bitmart exchange. Because pi network is still in the enclosed mainnet. The only way pioneers are able to trade pi coins is by reselling the pi coins to pi verified merchants.
A verified merchant is someone who buys pi network coins and resell it to exchanges looking forward to hold till mainnet launch.
I will leave the telegram contact of my personal pi merchant to trade with.
@Pi_vendor_247
how to sell pi coins effectively (from 50 - 100k pi)DOT TECH
Anywhere in the world, including Africa, America, and Europe, you can sell Pi Network Coins online and receive cash through online payment options.
Pi has not yet been launched on any exchange because we are currently using the confined Mainnet. The planned launch date for Pi is June 28, 2026.
Reselling to investors who want to hold until the mainnet launch in 2026 is currently the sole way to sell.
Consequently, right now. All you need to do is select the right pi network provider.
Who is a pi merchant?
An individual who buys coins from miners on the pi network and resells them to investors hoping to hang onto them until the mainnet is launched is known as a pi merchant.
debuts.
I'll provide you the Telegram username
@Pi_vendor_247
USDA Loans in California: A Comprehensive Overview.pptxmarketing367770
USDA Loans in California: A Comprehensive Overview
If you're dreaming of owning a home in California's rural or suburban areas, a USDA loan might be the perfect solution. The U.S. Department of Agriculture (USDA) offers these loans to help low-to-moderate-income individuals and families achieve homeownership.
Key Features of USDA Loans:
Zero Down Payment: USDA loans require no down payment, making homeownership more accessible.
Competitive Interest Rates: These loans often come with lower interest rates compared to conventional loans.
Flexible Credit Requirements: USDA loans have more lenient credit score requirements, helping those with less-than-perfect credit.
Guaranteed Loan Program: The USDA guarantees a portion of the loan, reducing risk for lenders and expanding borrowing options.
Eligibility Criteria:
Location: The property must be located in a USDA-designated rural or suburban area. Many areas in California qualify.
Income Limits: Applicants must meet income guidelines, which vary by region and household size.
Primary Residence: The home must be used as the borrower's primary residence.
Application Process:
Find a USDA-Approved Lender: Not all lenders offer USDA loans, so it's essential to choose one approved by the USDA.
Pre-Qualification: Determine your eligibility and the amount you can borrow.
Property Search: Look for properties in eligible rural or suburban areas.
Loan Application: Submit your application, including financial and personal information.
Processing and Approval: The lender and USDA will review your application. If approved, you can proceed to closing.
USDA loans are an excellent option for those looking to buy a home in California's rural and suburban areas. With no down payment and flexible requirements, these loans make homeownership more attainable for many families. Explore your eligibility today and take the first step toward owning your dream home.
Falcon stands out as a top-tier P2P Invoice Discounting platform in India, bridging esteemed blue-chip companies and eager investors. Our goal is to transform the investment landscape in India by establishing a comprehensive destination for borrowers and investors with diverse profiles and needs, all while minimizing risk. What sets Falcon apart is the elimination of intermediaries such as commercial banks and depository institutions, allowing investors to enjoy higher yields.
how can i use my minded pi coins I need some funds.DOT TECH
If you are interested in selling your pi coins, i have a verified pi merchant, who buys pi coins and resell them to exchanges looking forward to hold till mainnet launch.
Because the core team has announced that pi network will not be doing any pre-sale. The only way exchanges like huobi, bitmart and hotbit can get pi is by buying from miners.
Now a merchant stands in between these exchanges and the miners. As a link to make transactions smooth. Because right now in the enclosed mainnet you can't sell pi coins your self. You need the help of a merchant,
i will leave the telegram contact of my personal pi merchant below. 👇 I and my friends has traded more than 3000pi coins with him successfully.
@Pi_vendor_247
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when will pi network coin be available on crypto exchange.DOT TECH
There is no set date for when Pi coins will enter the market.
However, the developers are working hard to get them released as soon as possible.
Once they are available, users will be able to exchange other cryptocurrencies for Pi coins on designated exchanges.
But for now the only way to sell your pi coins is through verified pi vendor.
Here is the telegram contact of my personal pi vendor
@Pi_vendor_247
how to sell pi coins in South Korea profitably.DOT TECH
Yes. You can sell your pi network coins in South Korea or any other country, by finding a verified pi merchant
What is a verified pi merchant?
Since pi network is not launched yet on any exchange, the only way you can sell pi coins is by selling to a verified pi merchant, and this is because pi network is not launched yet on any exchange and no pre-sale or ico offerings Is done on pi.
Since there is no pre-sale, the only way exchanges can get pi is by buying from miners. So a pi merchant facilitates these transactions by acting as a bridge for both transactions.
How can i find a pi vendor/merchant?
Well for those who haven't traded with a pi merchant or who don't already have one. I will leave the telegram id of my personal pi merchant who i trade pi with.
Tele gram: @Pi_vendor_247
#pi #sell #nigeria #pinetwork #picoins #sellpi #Nigerian #tradepi #pinetworkcoins #sellmypi
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What price will pi network be listed on exchangesDOT TECH
The rate at which pi will be listed is practically unknown. But due to speculations surrounding it the predicted rate is tends to be from 30$ — 50$.
So if you are interested in selling your pi network coins at a high rate tho. Or you can't wait till the mainnet launch in 2026. You can easily trade your pi coins with a merchant.
A merchant is someone who buys pi coins from miners and resell them to Investors looking forward to hold massive quantities till mainnet launch.
I will leave the telegram contact of my personal pi vendor to trade with.
@Pi_vendor_247
how can I sell pi coins after successfully completing KYCDOT TECH
Pi coins is not launched yet in any exchange 💱 this means it's not swappable, the current pi displaying on coin market cap is the iou version of pi. And you can learn all about that on my previous post.
RIGHT NOW THE ONLY WAY you can sell pi coins is through verified pi merchants. A pi merchant is someone who buys pi coins and resell them to exchanges and crypto whales. Looking forward to hold massive quantities of pi coins before the mainnet launch.
This is because pi network is not doing any pre-sale or ico offerings, the only way to get my coins is from buying from miners. So a merchant facilitates the transactions between the miners and these exchanges holding pi.
I and my friends has sold more than 6000 pi coins successfully with this method. I will be happy to share the contact of my personal pi merchant. The one i trade with, if you have your own merchant you can trade with them. For those who are new.
Message: @Pi_vendor_247 on telegram.
I wouldn't advise you selling all percentage of the pi coins. Leave at least a before so its a win win during open mainnet. Have a nice day pioneers ♥️
#kyc #mainnet #picoins #pi #sellpi #piwallet
#pinetwork
how can I sell my pi coins for cash in a pi APPDOT TECH
You can't sell your pi coins in the pi network app. because it is not listed yet on any exchange.
The only way you can sell is by trading your pi coins with an investor (a person looking forward to hold massive amounts of pi coins before mainnet launch) .
You don't need to meet the investor directly all the trades are done with a pi vendor/merchant (a person that buys the pi coins from miners and resell it to investors)
I Will leave The telegram contact of my personal pi vendor, if you are finding a legitimate one.
@Pi_vendor_247
#pi network
#pi coins
#money
Introduction to Indian Financial System ()Avanish Goel
The financial system of a country is an important tool for economic development of the country, as it helps in creation of wealth by linking savings with investments.
It facilitates the flow of funds form the households (savers) to business firms (investors) to aid in wealth creation and development of both the parties
how to sell pi coins in all Africa Countries.DOT TECH
Yes. You can sell your pi network for other cryptocurrencies like Bitcoin, usdt , Ethereum and other currencies And this is done easily with the help from a pi merchant.
What is a pi merchant ?
Since pi is not launched yet in any exchange. The only way you can sell right now is through merchants.
A verified Pi merchant is someone who buys pi network coins from miners and resell them to investors looking forward to hold massive quantities of pi coins before mainnet launch in 2026.
I will leave the telegram contact of my personal pi merchant to trade with.
@Pi_vendor_247
The secret way to sell pi coins effortlessly.DOT TECH
Well as we all know pi isn't launched yet. But you can still sell your pi coins effortlessly because some whales in China are interested in holding massive pi coins. And they are willing to pay good money for it. If you are interested in selling I will leave a contact for you. Just telegram this number below. I sold about 3000 pi coins to him and he paid me immediately.
Telegram: @Pi_vendor_247
Offsetting Effects of Prescription Drug Use on Medicare’s Spending for Medical Services
1. Congressional Budget Office
Presentation to the AcademyHealth Annual Research Meeting
Melinda B. Buntin, Ph.D.
Deputy Assistant Director for Health
Tamara B. Hayford, Ph.D.
Principal Analyst
This presentation provides information published in Offsetting Effects of Prescription Drug Use on Medicare’s Spending
for Medical Services (November 2012). See http://www.cbo.gov/publication/43741
June 23, 2013
Offsetting Effects of Prescription Drug Use
on Medicare’s Spending for Medical Services
2. C O N G R E S S I O N A L B U D G E T O F F I C E
Overview
■ Why did CBO revisit the effect of changes in drug use on
medical service use?
■ How does the use of prescription drugs affect medical
spending?
■ Methodology and methodological issues to consider
■ Literature and results
■ Example of applying the medical-drug “offset”
3. C O N G R E S S I O N A L B U D G E T O F F I C E
Why Revisit the Relationship Between Drug Use
and Medical Spending?
• New evidence, advances in the literature
• Congressional interest in a range of drug cost-
sharing proposals, e.g.:
• Lower LIS generic copay and increase LIS brand copay
• Increase manufacturer’s discount in the coverage gap
• Fill the donut hole
4. C O N G R E S S I O N A L B U D G E T O F F I C E
Higher
cost to
enrollee
Less controlled
disease
• More complications
• More ER visits
• More hospitalizations
• Etc.
How a Drug Price Affects Medical Spending
Reduced Rx
Use
Reduced Rx
adherence
Reduced Rx
continuation
Might vary by…
Health of affected group
Size of change in Rx price
Direction of change in price
Lower Rx
Spending
5. C O N G R E S S I O N A L B U D G E T O F F I C E
Methodology:
Study Selection and Results Calibration
• Select studies:
• Analysis of changes in overall drug use
• Populations “applicable to” Medicare population
• Calibrate study results:
• Adjust to be consistent with overall Medicare population
• Adjust to be consistent with overall medical spending
• Scale to be consistent with a 1 percent change in
prescription drug use
• Calculate average of calibrated, scaled results weighted by
study quality
6. C O N G R E S S I O N A L B U D G E T O F F I C E
Issues to Consider
• Are effects symmetric to increases and decreases?
Linear?
• Can the factor be applied to subgroups of the Part D
population?
• Can we apply the logic to specific drug classes (e.g.
biologics)?
7. C O N G R E S S I O N A L B U D G E T O F F I C E
• One study estimated the impact of pharmaceutical
policies on a broad population outside of Medicare
(Gaynor, Li, & Vogt, 2007)
• Four studies estimated the impact of pharmaceutical
policies on Medicare beneficiaries prior to Part D
implementation (Chandra et al., 2010; Stuart et al.,
2009; Shang and Goldman, 2007; Hsu et al. 2006)
• Three studies compared medical expenditures before
and after Part D implementation (McWilliams et al.
2011; Afendulis et al. 2001; Zhang et al. 2009)
Estimates of the Size of the Offset
8. C O N G R E S S I O N A L B U D G E T O F F I C E
Effect of a 1 Percent Increase in Drug Use on Other
Medical Spending
Scaled Results Range -2/3 % to +1/3%
Scaled Range Excluding Max and Min -4/10% to -1/10%
Weighted Average -1/5 %
9. C O N G R E S S I O N A L B U D G E T O F F I C E
The relationship between changes in drug utilization and non-drug
medical spending appears to be symmetric and linear
-12
-10
-8
-6
-4
-2
0
2
4
6
8
-30 -20 -10 0 10 20 30
Calibrated%changeinnon-drugmedicalspending
% change in Rx utilization
Zhang et al (2009)
outlier
10. C O N G R E S S I O N A L B U D G E T O F F I C E
Applying the Offset
■ When?
– For policy changes that are estimated to change the quantity of drugs
consumed in the Medicare program
– Not for policy changes that affect other programs
– Not for policy changes that would not directly induce a change in the
quantity of drugs consumed
■ How?
– First: estimate a proposal’s direct effect on prescription drug costs
– Next: estimate the effect on the number of prescriptions filled
– Last: calculate any resulting offsetting effect on spending for medical
services.
11. C O N G R E S S I O N A L B U D G E T O F F I C E
Applicability to Population and Drug Subgroups
■ Population subgroups:
– CBO will apply the factor to policies affecting broad
subgroups (e.g., LIS or non-LIS population)
– Narrower populations decided on a case-by-case basis
(Study results may or may not be applicable)
■ Drug subgroups:
– Studies addressed changes in overall drug use
– Effects within therapeutic classes will require further
literature review for those classes
12. C O N G R E S S I O N A L B U D G E T O F F I C E
Example: Closing the Part D Coverage Gap
■ Components of closing the gap:
– 50% manufacturer’s discount on brand drugs in the coverage gap (for
non-LIS beneficiaries only) began in 2011.
– Part D Plans gradually responsible for more coverage until, in 2020,
they pay for 25% of brand drugs & 75% of generics.
■ Estimated effect:
– Total consumption of drugs by non-LIS will increase by 5% by 2018.
By 2018, spending for medical services expected to fall by 1% for this
population.
– For 2013-2022 period, Medicare medical spending estimated to fall by
$35 billion (out of $5.6 trillion).
Estimated cost of closing the gap for 2013-2022 period drops from $86
billion to $51 billion.