Top 200 prescription drugs 2018 in usa pdf download

Please see our commenting policy for details. Question How has the concentration of health care spending in the US changed by population subgroup and expenditure type between and ? Findings In this cross-sectional study, the overall concentration of health care expenditures remained stable, although there was a sharp increase in the concentration of spending on prescription drugs. In , one-half of all expenditures on prescription drugs were concentrated in 6.

Meaning These findings suggest that if this trend continues, it will have implications for the minimum scale of risk-bearing and drug management needed for health insurance plans to operate efficiently, as well as the optimal cost-sharing features of insurance products. Importance The concentration of health care expenditures has important implications for managing risk pools, drug benefit design, and care management. Objective To examine trends in the concentration of health care spending in different population groups and expenditure categories in the US between and Respondents were a nationally representative sample of the US civilian noninstitutionalized population.

Data analysis was performed from December to February Main Outcomes and Measures The main outcome is the concentration of health care expenditures as measured by the cumulative percentage of health expenditure vs percentage of ranked population. Although this fraction varied across population groups or expenditure categories, it remained remarkably stable over time with one exception: the concentration of spending on prescription drugs.

This change does not appear to be associated with a change in the overall share of prescription drug expenses, which increased by only a small amount, from Conclusions and Relevance The overall concentration of health care expenditures remained stable between and , but these findings suggest that there has been a sharp increase in the concentration of spending on prescription drugs in the US. This coincides with the genericization of many primary care drugs, along with a shift in focus of the biopharmaceutical industry toward high-cost specialty drugs targeted at smaller populations.

If this trend continues, it will have implications for the minimum scale of risk-bearing and drug management needed to operate efficiently, as well as the optimal cost-sharing features of insurance products. The concentration curve of cumulative percentage of health care expenditure vs percentage of ranked population is a powerful instrument in the analysis of health care costs. One key advantage is that it is intrinsically dimensionless and allows direct comparisons between populations of various types, in different expenditure categories, and across time periods irrespective of factors such as inflation or size adjustments.

Despite that versatility, published analyses 1 , 2 tend to focus on one or another feature of interest of the concentration curve rather than taking a broader view. The yearly Medical Expenditure Panel Survey MEPS provides a large data set on health care spending in the US, with considerable granularity on expenditure categories and population groups. We used those data to construct a comprehensive set of concentration curves.

We have considered not only the high-spender bracket but also analyzed other brackets, such as low spenders and nonspenders, as was done by Berk and Fang. In this study, we focus on a presentation of our most important findings; in general, for a given population segment or spending category, concentration curves have been remarkably stable over time, with one notable exception, prescription drug expenditures.

However, we also provide a comprehensive set of summarized concentration curve parameters as a general resource to the community in eAppendix 1, eAppendix 2, and eAppendix 3 in the Supplement a URL for a public repository containing these tables as Excel files is shown at the end of the article. Our analysis sought to answer the following questions: How is the concentration of health care spending changing in the US over time?

What are the differences in concentration curves between population groups eg, income and insurance type? What are the differences in concentration curves between expenditure categories eg, outpatient vs inpatient?

How do these concentration curves change over time? The findings presented in this cross-sectional study come from an analysis of MEPS full-year consolidated data files, which contain data on surveys conducted between and MEPS is a survey of a nationally representative sample of the US civilian noninstitutionalized population that achieves a high level of accuracy in its expenditure estimates by validating household-reported expenditure data with data from health care facilities eg, hospitals, outpatients facilities, and pharmacies.

Cohen et al 4 provide a detailed overview and discussion of MEPS. MEPS data are publicly available, and there is no patient consent form available for download.

We used variables measuring health insurance status, income, and diagnostic group to study differences in expenditure concentrations across population subgroups. To classify individuals into insurance groups, we used the following hierarchy: 1 any public insurance at the end of the year, 2 any private insurance during the year, and 3 uninsured for the entire year.

Individuals were assigned to income groups according to the total yearly income of their family. Income group classifications were based on family income relative to the poverty line and were the same as those used by previous analyses.

Our calculation of total health care expenditures did not include vision aids and dental expenditures because they operate differently from core health care expenditure categories ie, they are usually covered separately by insurers and have a high cash component, and a significant portion of spending has cosmetic intent.

To study the concentration of different types of health care expenditures, we used MEPS health service category expenditure variables. Prescription drug expenditure includes all spending on prescribed medicines by the respondent and is derived from pharmacy claims data. Spending on drugs administered as part of a medical encounter is not included in prescription drug expenditures.

Expenditure on emergency care resulting in an inpatient stay is included under inpatient care expenditure, and all other spending on emergency care is included under emergency care expenditure. Expenditures on home health and other medical supplies and equipment were combined under home health and equipment. The expenditure brackets that we studied were mutually exclusive and were formed by ordering sampled persons by their expenditures and then allocating persons to brackets according to weighted cumulative expenditures.

Note that in any category or subgroup analysis, persons were reordered and brackets were recalculated ie, a specific person might be in a different bracket depending on the specific analysis. Before excluding dental and vision expenditures from the total expenditure calculation, we validated our methods by replicating the results of a recent report on health care expenditure concentration that also used MEPS data.

Data analysis was performed using RStudio statistical software version 1. National estimates were based on survey weights and annual samples of MEPS survey respondents. In , The concentration of health care expenditures across various expenditure brackets has been strikingly stable. This is a surprise given that, during this period, there have been substantial changes in US demographic characteristics eg, an aging population and increasing diversity and in health care coverage models eg, the Patient Protection and Affordable Care Act.

What is notable is that although there are significant differences in the concentration of expenditures between groups and categories, the concentrations have been stable over time, with a few exceptions discussed later. That costs are much more concentrated among individuals with private insurance than for individuals with Medicare is not surprising and is consistent with prior findings.

There are 3 exceptions to the stability of concentration. First, cost has become more concentrated among the uninsured. The Patient Protection and Affordable Care Act has been associated with more individuals with health issues getting insured, and the uninsured have become younger and healthier, which, in turn, leads to more concentrated costs.

Third, for prescription drugs, there has been a sharp increase in the concentration of expenditures. Figure 2 shows that in , 6. Credit goes to the emergence of scientific research methods. Research on the disease, its causes, effects, precaution, … Expand.

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The Role of the Pharmacist in Health Care. A new analysis by Avalere Health set out to investigate the ways that pharmacist services are improving care, and how these services are aligned with the changing healthcare environment. With support … Expand. A new free graphical teaching tool that highlights the beautiful organic architectures of the top selling pharmaceuticals is detailed on two posters. In addition to the multitude of teaching and … Expand.

The preparation of p-thymotic acid and its derivatives. The Top Drugs of Prescribed drugs as a tool for pharmacy teaching and training. Related Papers. This Top drugs list is current for and is based on previous years total prescriptions by volume dispensed. It is loosely translated from an unofficial top list of drugs dispensed. However, modified because certain drugs have been omitted, mainly because they would not likely be included on the official pharmacy tech test PTCB.

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