New Drug Spending Tool May be Helpful for Researchers and Policymakers—Not Much Help for Consumers

This week, the Centers for Medicare & Medicaid Services (CMS) released new data and a new tool on prescription medication: the Drug Spending Dashboard. The Dashboard allows users to see list prices of various medications, how many manufacturers supply the drug, what they have been paid by Medicare—both Part B and Part D—and Medicaid, total and per beneficiary spending on the drug, and comparisons of spending from 2015 to 2016. Such data show trends in both drug pricing and program spending, and CMS offers additional data for use outside of the Dashboard.

The Administration’s recent focus on drug pricing is bringing attention to this important issue, and to tools and data that may help address the high cost of prescription drugs. However, while the Dashboard provides insights into drug pricing and the effects on the Medicare and Medicaid programs, it may be more helpful to researchers and policymakers than to people with Medicare. The prices the Dashboard shows are the “list prices,” which are the prices drug manufacturers request prior to any rebates or negotiations; they are not the prices people with Medicare actually pay. The Dashboard does not show the consumer prices or indicate which plans will cover which drugs on their formularies. This information is important from a beneficiary perspective because it gets at the actual costs they will face when they pick up their medications at the pharmacy.

The Dashboard is also limited in that it does not capture and show how much each Medicare beneficiary will ultimately pay for each drug. Such costs are difficult to estimate, as they are dependent on a number of highly specific, individualized factors, including the beneficiary’s prescription drug needs and their plan’s deductible and formulary tiering. However, the lack of this information makes the tool of very limited use for consumers.

At Medicare Rights, we welcome a focus on transparency in the Medicare program and see the Dashboard as a step in the right direction for future actions that will reduce drug costs and increase the affordability of prescriptions for all. While the Dashboard tool cannot show which drugs are the best value, people with Medicare and others may find the information interesting and informative.

Access the Drug Spending Dashboard.