{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:06:50Z","timestamp":1787242010955,"version":"build-2736575974"},"reference-count":30,"publisher":"American Medical Association (AMA)","issue":"15","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2022,10,18]]},"abstract":"\n Importance<\/jats:title>\n Prescription drug spending is a topic of increased interest to the public and policymakers. However, prior assessments have been limited by focusing on retail spending (Part D\u2013covered drugs), omitting clinician-administered (Part B\u2013covered) drug spending, or focusing on all fee-for-service Medicare beneficiaries, regardless of their enrollment into prescription drug coverage.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To estimate the proportion of health care spending contributed by prescription drugs and to assess spending for retail and clinician-administered prescriptions.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Descriptive, serial, cross-sectional analysis of a 20% random sample of fee-for-service Medicare beneficiaries in the United States from 2008 to 2019 who were continuously enrolled in Parts A (hospital), B (medical), and D (prescription drug) benefits, and not in Medicare Advantage.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Calendar year.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Net spending on retail (Part D\u2013covered) and clinician-administered (Part B\u2013covered) prescription drugs; prescription drug spending (spending on Part B\u2013covered and Part D\u2013covered drugs) as a percentage of total per-capita health care spending. Measures were adjusted for inflation and for postsale rebates (for Part D\u2013covered drugs).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There were 3\u202f201\u202f284 beneficiaries enrolled in Parts A, B, and D in 2008 and 4\u202f502\u202f718 in 2019. In 2019, beneficiaries had a mean (SD) age of 71.7 (12.0) years, documented sex was female for 57.7%, and 69.5% had no low-income subsidies. Total per-capita spending was $16\u202f345 in 2008 and $20\u202f117 in 2019. Comparing 2008 with 2019, per-capita Part A spending was $7106 (95% CI, $7084-$7128) vs $7120 (95% CI, $7098-$7141), Part B drug spending was $720 (95% CI, $713-$728) vs $1641 (95% CI, $1629-$1653), Part B nondrug spending was $5113 (95% CI, $5105-$5122) vs $6702 (95% CI, $6692-$6712), and Part D net spending was $3122 (95% CI, $3117-$3127) vs $3477 (95% CI, $3466-$3489). The proportion of total annual spending attributed to prescription drugs increased from 24.0% in 2008 to 27.2% in 2019, net of estimated rebates and discounts.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In 2019, spending on prescription drugs represented approximately 27% of total spending among fee-for-service Medicare beneficiaries enrolled in Part D, even after accounting for postsale rebates.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2022.17825","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T11:32:35Z","timestamp":1666092755000},"page":"1515","source":"Crossref","is-referenced-by-count":26,"title":["Prescription Drug Spending in Fee-for-Service Medicare, 2008-2019"],"prefix":"10.1001","volume":"328","author":[{"given":"Stacie B.","family":"Dusetzina","sequence":"first","affiliation":[{"name":"Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee"},{"name":"Vanderbilt-Ingram Cancer Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiden A.","family":"Huskamp","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanzi","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy L.","family":"Keating","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts"},{"name":"Division of General Internal Medicine, Brigham and Women\u2019s Hospital, Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"9","key":"joi220105r1","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1001\/jama.2020.1012","article-title":"Changes in list prices, net prices, and discounts for branded drugs in the US, 2007-2018.","volume":"323","author":"Hernandez","year":"2020","journal-title":"JAMA"},{"issue":"21","key":"joi220105r2","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1001\/jama.2022.5542","article-title":"Trends in prescription drug launch prices, 2008-2021.","volume":"327","author":"Rome","year":"2022","journal-title":"JAMA"},{"issue":"8","key":"joi220105r3","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1001\/jama.2016.11237","article-title":"The high cost of prescription drugs in the United States: origins and prospects for reform.","volume":"316","author":"Kesselheim","year":"2016","journal-title":"JAMA"},{"issue":"4","key":"joi220105r4","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1377\/hlthaff.2021.01742","article-title":"Many Medicare beneficiaries do not fill high-price specialty drug prescriptions.","volume":"41","author":"Dusetzina","year":"2022","journal-title":"Health Aff (Millwood)"},{"key":"joi220105r7","doi-asserted-by":"crossref","DOI":"10.1377\/hlthaff.2018.05085","article-title":"National health care spending in 2017: growth slows to post-Great Recession rates; 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Therapeutic drug use. Accessed July 25, 2022. https:\/\/www.cdc.gov\/nchs\/fastats\/drug-use-therapeutic.htm"},{"key":"joi220105r10","unstructured":"Congressional Budget Office. Prescription drugs: spending, use, and prices. Accessed July 25, 2022. https:\/\/www.cbo.gov\/publication\/57772"},{"key":"joi220105r11","unstructured":"Mathews? JE. Payment policy for prescription 10 drugs under Medicare Part B and Part D: statement of James E. Mathews, PhD, executive director, Medicare Payment Advisory Commission, before the Subcommittee on Health, Committee on Energy and Commerce, US House of Representatives. April 30, 2019. Accessed September 20, 2022. https:\/\/www.medpac.gov\/wp-content\/uploads\/import_data\/scrape_files\/docs\/default-source\/congressional-testimony\/04_30_2019_medpac_drug_testimony_for_eandc.pdf"},{"key":"joi220105r12","unstructured":"Cubanski? J, Rae? M, Young? K, Damico? A. 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