Adewole S. Adamson

Characteristics of Medicare Payments to Dermatologists in 2013

Characteristics of Medicare Payments to Dermatologists in 2013 Dermatologists provide many types of medical and procedural services, yet little is known about how Medicare payments to dermatologists vary by the type of service performed. In April 2014, the Centers for Medicare & Medicaid Services released the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF).1 For the first time, the public had access to Medicare payments to health care professionals. Although these payments are not sufficient to determine value, physician payments are part of the value equation and will be a continued source of scrutiny. This study examines the characteristics of Medicare payments to dermatologists.

Medicare Part D Payments for Topical Steroids: Rising Costs and Potential Savings

Importance Rising pharmaceutical costs in the United States are an increasing source of financial burden for payers and patients. Although topical steroids are among the most commonly prescribed medications in dermatology, there are limited data on steroid-related spending and utilization. Objective To characterize Medicare and patient out-of-pocket costs for topical steroids, and to model potential savings that could result from substitution of the cheapest topical steroid from the corresponding potency class. Design, Setting, and Participants This study was a retrospective cost analysis of the Medicare Part D Prescriber Public Use File, which details annual drug utilization and spending on both generic and branded drugs from 2011 to 2015 by Medicare Part D participants who filled prescriptions for topical steroids. Main Outcomes and Measures Total and potential Medicare and out-of-pocket patient spending. Costs were adjusted for inflation and reported in 2015 dollars. Results Medicare Part D expenditures on topical steroids between 2011 and 2015 were

Association Between Method of Prescribing and Primary Nonadherence to Dermatologic Medication in an Urban Hospital Population.

2.3 billion. Patients’ out-of-pocket spending for topical steroids over the same period was

Association of Delays in Surgery for Melanoma With Insurance Type

333.7 million. The total annual spending increased from

Geographic Distribution of Nonphysician Clinicians Who Independently Billed Medicare for Common Dermatologic Services in 2014

237.6 million to

Prescription-level factors associated with primary nonadherence to dermatologic medications

775.9 million, an increase of 226.5%. Patients’ annual out-of-pocket spending increased from

Patient-provider race and sex concordance and the risk for medication primary nonadherence

41.4 million to

Medicare Part D payments for brand and generic drugs prescribed by Dermatologists

101.8 million, an increase of 145.9%. The total number of prescriptions were 7.7 million in 2011 and 10.6 million in 2015, an increase of 37.0%. Generic medication costs accounted for 97.8% of the total spending during this time period. The potential health care savings and out-of-pocket patient savings from substitution of the cheapest topical steroid within the corresponding potency class were

LB1499 Impact of industry payments on prescribing patterns for TNF-α inhibitors among Medicare beneficiaries

944.8 million and

Impact of Industry Payments on Prescribing Patterns for Tumor Necrosis Factor Inhibitors Among Medicare Beneficiaries

66.6 million, respectively. Conclusions and Relevance Most topical steroids prescribed were generic drugs. There has been a sharp increase in Medicare and out-of-pocket spending on topical steroids that is driven by higher costs for generics. Use of clinical decision support tools to enable substitution of the most affordable generic topical steroid from the corresponding potency class may reduce drug expenditures.