MHDO Prescription Drug Reports

In 2018, the Maine State Legislature enacted LD 1406, “An Act To Promote Prescription Drug Price Transparency.” The new law directs the Maine Health Data Organization (MHDO) to produce an annual prescription drug report, beginning in December 2018 that includes the following information:

  1. The 25 most frequently prescribed drugs in the State;
  2. The 25 costliest drugs as determined by the total amount spent on those drugs in the State; and
  3. The 25 drugs with the highest year-over-year cost increases as determined by the total amount spent on those drugs in the State.

See Memo and Summary of Reports sent to the Judiciary Committee

Using the Interactive Prescription Drug Reports

Use this interactive Prescription Drug report to learn more about prescription drug utilization and costs in Maine. All three prescription drug reports present information based on prescriptions filled between July 1, 2017 and June 30, 2018 that are available in the MHDO’s All-Payer Claims Database (APCD).

First, select whether you are interested in the Top 25 Costliest Drugs, the Top 25 Most Frequently Prescribed Drugs, or the Top 25 Drugs with the Highest Year-Over-Year Cost Increases. As a default on each dashboard you are shown the results for Brand or Generic drugs and the Overall Payer Type, which is a combination of pharmacy claims from Commercial, Medicaid and Medicare Advantage Plans. The display shows the National Drug Code (NDC), drug name, drug class(es), number of prescriptions, number of prescription users, total cost of the drug, cost per prescription and—in the case of the report showing year-over-year change—the difference in total cost between the most recent and previous 12-month period.

You can then select the Brand or Generic drop-down to focus results on brand name drugs or generic drugs only, or select Brand or Generic to compare all drugs. Then you can select Payer Type to view all Commercial, MaineCare, or Medicare Advantage payers in Maine or to see Overall costs across all payer types.

You can also hover over the Number of Prescriptions, Number of Prescription Users, Cost, Cost Per Prescription, or Year-Over-Year Increase columns for additional information about the particular drug. This text includes whether the drug is generic or brand name. It also provides a more detailed description of the drug’s therapeutic class, such as Insulins or Antidepressants. The text also provides additional metrics such as the cost per prescription user per year. Please note that the more detailed description described above appears when you hover over the numbers.

Overview of the Methodology Used to Generate Reports

The new MHDO interactive prescription drug reports include a count of how frequently a particular medication was prescribed between July 1, 2017 and June 30, 2018 (Number of Prescriptions), and the total amount spent on those drugs (Cost). These analyses focus on prescription drugs purchased at a retail pharmacy including mail-order; they exclude medications that appear on medical claims and those purchased over the counter. The number of prescriptions is calculated across all prescriptions for a particular drug, regardless of variation in the quantity dispensed or the number of days of supply. The Cost Per Prescription is calculated as the total cost divided by the count of prescriptions and, similarly, it does not take into account the quantity dispensed or the number of days of supply. Furthermore, the Cost Per Prescription User Per Year is approximated based on the total dollar amount the insurance company and the insured individual paid a pharmacy for prescriptions of the drug divided by the number of individuals that filled the prescription during the year. The reporting time represents the most recent available 12 months of data as of the date of publication. Additionally, data from the previous 12 months were analyzed to ascertain year-over-year cost increases.

Each analysis is conducted at the level of the 11-digit National Drug Code, a unique, three-segment number that serves as a universal product identifier for drugs. The NDC identifies the chemical compound in the drug, the labeler (usually the manufacturer), and the type of packaging. It is more precise than drug name alone.

These reports include tables for each payer type—Commercial, MaineCare, Medicare Advantage, along with an Overall (all-payer) category—and for brand-name or generic drugs.

Sources

The data in these reports was extracted from pharmacy claims data in the MHDO APCD. The reports use the American Hospital Formulary Service (AHFS) Drug Information to provide additional contextual information on the types of therapies each drug is prescribed for. This is shown in the dashboard as Drug Class. Supplemental use-case information available in the written report comes from the FDA or the manufacturer websites.

For more information on how to interpret an NDC code: https://www.fda.gov/drugs/developmentapprovalprocess/ucm070829