Trends in Prescriptions and Spending of Anti-seizure Medications in Medicaid and Medicare Part D from 2012-2020
Abstract number :
1.388
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2022
Submission ID :
2204062
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Abdulmohsen Ghuloum, BS – Wayne State University School of Medicine; Wesley Kohls, BS – Medical Student, Neurology, Wayne State University School of Medicine; Jason Liu, BS – Medical Student, Neurology, Wayne State University School of Medicine; Deepti Zutshi, MD – Associate Professor, Neurology, Wayne State University School of Medicine
Rationale: Epilepsy affects nearly 3.4 million individuals in the United States, with the majority comprising older adults and children. In 2019, 1.1 million individuals with epilepsy received care via Medicare, and 32.7% of patients 18 and older were covered via Medicaid in 2015. Our objective was to analyze trends in anti-seizure medication (ASM) prescriptions and spending in Medicare Part D and Medicaid between the years 2012 and 2020.
Methods: All data were collected from publicly available Medicare Part D (MPD) Spending by Drug database and Medicaid Spending by Drug database from 2012 to 2020. Data was filtered based on ASMs and analyzed according to drug mechanism of action, drug generation, and “brand-vs.-generic.” Gabapentin and pregabalin were excluded from analysis as they have multiple other indications of use.
Results: MPD expenses on ASMs increased from $1.16 billion in 2012 to $2.68 billion in 2020. The total spent on 3rd-generation ASMs was $124 million in 2012 (10.7%) and $1.08 billion in 2020 (40.4%). MPD had 19.2 million total claims in 2012 and 24.8 million claims in 2020. The total number of claims of 3rd-generation ASMs was 240,000 in 2012 (1.3 %) and 1.10 million in 2020 (4.44%). The total spent on brand name ASMs increased nearly three-fold from $546 million in 2012 (46.8% of all funding spent on ASMs) to $1.62 billion in 2020 (60.2% of all funding spent on ASMs). Meanwhile, the number of claims for brand name ASMs only accounted for 9.24% of total claims in 2012 and 6.62% of total claims in 2020.
Medicaid expenditure on ASMs doubled from $973 million in 2012 to $2.05 billion in 2020. Medicaid had 13.1 million total claims in 2012 which increased to 18.7 million claims in 2020. Third generation ASMs accounted for 1.7% of total claims in 2012 and 6% in 2020. However, expenditure on 3rd-generation ASMs had a nearly eight-fold increase from $147 million (15.1% of all funding spent on ASMs) in 2012 to $1.15 billion in 2020 (56.1%), more than the total expenditure on first- and second-generation ASMs combined. The total spent of brand name ASMs was $605 million in 2012 and $1.46 billion in 2020. This accounts for 62.2% of total spending in 2012 and 71.3% of total spending in 2020, despite the percentage of total claims for brand name ASMs accounted for 12.1% in 2012 and 6.8% in 2020.
Conclusions: In the past decade, spending by the United States Medicare and Medicaid systems on anti-seizure medications has doubled. This spending has been disproportionately comprised of newer third-generation and brand-name ASMs. It will be vital to continue monitoring trends in spending by Medicare and Medicaid given the current and expected increase in life expectancy with the associated increase in epilepsy prevalence with age.
Funding: No funding was received for this abstract.
Health Services (Delivery of Care, Access to Care, Health Care Models)