Medicare patients with MS bear the burden of rising drug prices

August 27, 2019
During the course of a decade, out-of-pocket costs for multiple sclerosis drugs rose more than sevenfold for Medicare Part D beneficiaries, according to a new study. The study’s authors wanted to see how increases in list prices drugs – the starting point before rebates, coupons or insurance kicks in – translated to increases in out-of-pocket spending, and discovered that actual price increases do get passed down to patients, and that can negatively affect access.

Using Medicare claims data from 2006-2016, researchers at the University of Pittsburgh looked at trends in MS drug prices over time. During the time period studied, the annual list prices of these more than quadrupled, ballooning from about $18,000 to nearly $76,000 per patient per year. 

Although this trend among list prices is alarming on its own, critics have argued that because some of the cost is canceled out by manufacturer rebates and other kinds of discounts, rising list prices may not be translating into increased spending. 

But because Medicare claims provide a detailed cost breakdown, the researchers were able to measure changes in what Medicare Part D beneficiaries actually paid out of pocket for MS drugs, as well as what Medicare itself paid. Not only did they find steep increases in list prices, but also in the ultimate costs to both Medicare and its recipients.

According to the study, Medicare spending increased by more than tenfold from 2006-2016, and the patients themselves saw more than a sevenfold increase in their share of the bill.

The findings were published in JAMA Neurology.

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