Pharmacy Costs

Pharmacy Costs

For More Information on
Total Prescription Drug Spending and Rebates,
see CHIA's 2018 Annual Report

CHIA annual report 2018 cover

In the 2017 Annual Report on the Performance of the Massachusetts Health Care System, CHIA identified pharmacy spending as a major component of total health care expenditures in Massachusetts, representing over 18% of commercial spending in 2015 and 2016. To further understand this important sector of the health care system, this report looks at drivers of pharmacy spending and presents information on high volume and high cost drugs, as well as the associated illnesses they are used to treat.

The report concentrates on the top 10 therapeutic classes of drugs, as ranked by total expenditures incurred during fiscal year 2015. These classes accounted for 71.3% of pharmacy expenditures during that time period. In addition to presenting average costs by therapeutic class, the report contains detailed pages for each class, showing average costs for the top five most frequently prescribed drugs within the class.

CHIA's initial report, Prescription Drug Use and Spending (August 2018) utilizes a subset of pharmacy claims data sourced from CHIA’s All Payer Claims Database (APCD).

Future reporting on pharmacy spending by therapeutic class will also incorporate analyses of changes over time to help identify shifting patterns of utilization, costs, and other factors.

Pharmacy Expenditures by Therapeutic-Class, SFY 2015