Longitudinal studies are needed to analyze Medicare Part D prescription trends in use and the rising costs of dermatology medications, according to findings in a research letter published in the Journal of American Academy of Dermatology.

Observing that prescription patterns for dermatology medications have not been studied longitudinally in recent years, researchers analyzed claims and cost trends of prescribed dermatology medications from 2013 to 2019. Data were sourced from the Centers for Medicare & Medicaid Medicare Part D; researchers calculated daily costs (total drug cost divided by total days’ supply).

The cost of prescribed medications decreased during 6 years for the top 10 medications chosen: clobetasol propionate, triamcinolone acetonide, ketoconazole, fluocinonide, mupirocin, desonide, doxycycline hyclate, cephalexin, fluorouracil, and metronidazole. Clobetasol was the most prescribed drug in 2013, with a daily dose cost of $1.88. By 2019, there was a 93.6% cost increase to $3.64. Desonide was no longer ranked in the top 10 claims by 2019. Claims for desonide decreased drastically from 247,589 in 2017 to 38,840 in 2018, which may be attributable to price increases in manufacturing. Doxycycline monohydrate peaked in daily dose cost of $4.58 in 2014 and decreased thereafter. Etanercept was the most expensive drug in the top 50 most prescribed dermatology medications, with a median point-of-sale cost of $5757.


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Limitations of this study include access to data that relate only to Medicare Part D beneficiaries. The statistical analysis may not have been adequately powered; researchers were unclear as to whether cost decreases caused quantities to decrease or vice versa.

“We hope to inform clinicians and policymakers of trends in dermatologic drug prescription volume and cost,” the study authors concluded. “A need remains for transparent pricing and drug-pricing reforms.”

Reference 

Hwang AS, Pollock JR, Buras MR, Mangold AR, Swanson DL. Medicare part D prescription trends in use and cost of dermatology medications. Published online Dec 27, 2021. J Am Acad Dermatol. doi:10.1016/j.jaad.2021.12.036