Medicaid's Most Costly Outpatient Drugs

Appendix A: Tables

Appendix Table A1: Medicaid’s 50 Most Costly Drugs, 2014Q1 – 2015Q2
Ranking Drug Name Specialty Drug Biologic Orphan Drug Single-Source or Brand  (B) vs. Multi-Source Generic (G) Drug Group Medicaid Spending Per Prescription Percentile* Number of Prescriptions Percentile**
1 Abilify X B Antipsychotics/Antimanic Agents 90th 99th
2 Sovaldi X B Antivirals 99th 75th
3 Vyvanse B ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants 75th 99th
4 Harvoni X B Antivirals 99th 75th
5 Truvada X B Antivirals 90th 95th
6 Lantus B Antidiabetics 75th 95th
7 Methylphenidate HCl ER B & G ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants 75th 99th
8 Atripla X B Antivirals 95th 95th
9 Advair Diskus B Antiasthmatic and Bronchodilator Agents 75th 95th
10 Lantus SoloStar B Antidiabetics 75th 95th
11 Seroquel XR B Antipsychotics/Antimanic Agents 90th 95th
12 Latuda B Antipsychotics/Antimanic Agents 90th 95th
13 Humira Pen X X X B Anti-Inflammatory Analgesics 95th 90th
14 Adderall XR B ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants 75th 95th
15 Suboxone X B Opioid Analgesics 75th 95th
16 Invega Sustenna B Antipsychotics/Antimanic Agents 90th 95th
17 Flovent HFA B Antiasthmatic and Bronchodilator Agents 75th 95th
18 Lyrica B Anticonvulsants 75th 95th
19 Spiriva HandiHaler X B Antiasthmatic and Bronchodilator Agents 75th 95th
20 ProAir HFA B Antiasthmatic and Bronchodilator Agents 50th 99th
21 Symbicort B Antiasthmatic and Bronchodilator Agents 75th 95th
22 Intuniv B ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants 75th 95th
23 Synagis X X B Passive Immunizing Agents 95th 90th
24 Prezista X B Antivirals 90th 95th
25 Stribild X B Antivirals 95th 90th
26 Advate X X B Hematological Agents 99th 75th
27 Ventolin HFA B Antiasthmatic and Bronchodilator Agents 50th 99th
28 Focalin XR B ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants 75th 95th
29 Strattera X B ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants 75th 95th
30 Qvar B Antiasthmatic and Bronchodilator Agents 50th 95th
31 Januvia B Antidiabetics 75th 95th
32 Humalog B Antidiabetics 75th 95th
33 Complera X B Antivirals 95th 90th
34 Reyataz X B Antivirals 90th 90th
35 Copaxone X X B Psychotherapeutic and Neurological Agents 95th 75th
36 Duloxetine HCl G Antidepressants 50th 95th
37 Hydrocodone-Acetaminophen B & G Opioid Analgesics 25th 99th
38 Tamiflu B Antivirals 75th 95th
39 Nexium B Ulcer Drugs 75th 95th
40 Enbrel SureClick X X X B Anti-Inflammatory Analgesics 95th 90th
41 Neulasta X X X B Hematopoietic Agents 95th 90th
42 Novolog FlexPen B Antidiabetics 75th 95th
43 NovoSeven RT X X X B Hematological Agents 99th 50th
44 Norditropin FlexPro X X B Endocrine and Metabolic Agents 95th 90th
45 Isentress X B Antivirals 90th 90th
46 Divalproex Sodium ER G Anticonvulsants 50th 95th
47 Seroquel B Antipsychotics/Antimanic Agents 75th 95th
48 Budesonide X B & G Antiasthmatic and Bronchodilator Agents 75th 95th
49 Invega B Antipsychotics/Antimanic Agents 90th 90th
50 Amphetamine-Dextroamphet ER G ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants 50th 95th
*We calculated average spending before rebates per prescription for each drug over the 2014Q1-2015Q2 period and identified notable percentiles. Medicaid Spending Per Prescription Percentile reflects how expensive each drug is before rebates at the prescription level, with respect to other Medicaid-reimbursed drugs, with 99th being the most expensive.

**We summed the number of prescriptions for each drug over the 2014Q1-2015Q2 period and identified notable percentiles. Number of Prescriptions Percentile reflects how frequently prescribed each drug is, with respect to other Medicaid-reimbursed drugs, with 99th being the most prescribed.

Appendix Table A2: Medicaid’s Most Expensive Drugs by Spending per Rx, 2014Q1 – 2015Q2
Ranking Drug Name Average Medicaid Spending
Before Rebates Per Rx
Specialty Drug Biologic Drug Group
1 NovoSeven RT $58,843 X X Hematological Agents
2 Koate-DVI $57,162 X X Hematological Agents
3 Feiba $48,366 X X Hematological Agents
4 Adagen $44,551 Miscellaneous Biologicals
5 HP Acthar $43,877 X Endocrine and Metabolic Agents
6 Vimizim $40,571 X X Endocrine and Metabolic Agents
7 Myalept $39,945 X X Endocrine and Metabolic Agents
8 Chenodal $39,556 Gastrointestinal Agents
9 Carbaglu $39,100 X Endocrine and Metabolic Agents
10 Feiba NF $36,418 X X Hematological Agents
11 Ruconest $33,659 X X Hematological Agents
12 Gattex $31,854 X Gastrointestinal Agents
13 Cinryze $31,640 X X Hematological Agents
14 Firazyr $31,103 X Hematological Agents
15 Alprolix $30,743 X X Hematological Agents
16 Harvoni $28,977 X Antivirals
17 Novoeight $28,897 X X Hematological Agents
18 Alphanate/VWF Complex/Human $28,571 X X Hematological Agents
19 Juxtapid $28,502 Antihyperlipidemics
20 Rixubis $28,330 X X Hematological Agents
21 Cholbam $27,422 Gastrointestinal Agents
22 Berinert $26,890 X X Hematological Agents
23 Procysbi $26,753 X Genitourinary Agents
24 Sovaldi $26,612 X Antivirals
25 Orfadin $26,562 Endocrine and Metabolic Agents
26 Actimmune $26,480 X X Antineoplastics and Adjunctive Therapies
27 Cerdelga $26,053 X Hematopoietic Agents
28 Viekira Pak $25,952 X Antivirals
29 Ravicti $25,840 X Endocrine and Metabolic Agents
30 Hemofil M $25,205 X X Hematological Agents
31 Eloctate $24,906 X X Hematological Agents
32 Xyntha Solofuse $23,846 X X Hematological Agents
33 Kalydeco $22,750 X Respiratory Agents
34 Zavesca $22,653 X Hematopoietic Agents
35 Mononine $22,647 X X Hematological Agents
36 Ceprotin $21,859 X X Hematological Agents
37 Yervoy $21,354 X X Antineoplastics and Adjunctive Therapies
38 Olysio $21,060 X Antivirals
39 Kalbitor $20,946 X X Hematological Agents
40 Incivek $20,575 X Antivirals
41 BeneFIX $20,019 X X Hematological Agents
42 Kogenate FS $20,017 X X Hematological Agents
43 Kynamro $19,731 X Antihyperlipidemics
44 Corifact $19,539 X X Hematological Agents
45 Arcalyst $19,014 X X Anti-inflammatory Analgesics
46 Lumizyme $18,855 X X Endocrine and Metabolic Agents
47 Kogenate FS Bio-Set $18,710 X X Hematological Agents
48 AlphaNine SD $18,389 X X Hematological Agents
49 Ilaris $18,133 X X Anti-inflammatory Analgesics
50 Supprelin LA $18,113 X Endocrine and Metabolic Agents
NOTE: This table reflects Medicaid spending before rebates per prescription. A course of treatment for an illness may require multiple prescriptions. For example, a full treatment course for Hepatitis C agents Sovaldi and Harvoni often lasts three months and may require multiple prescriptions.
Appendix Table A3: Medicaid’s Most Prescribed Drugs, 2014Q1 – 2015Q2
Ranking Drug Name Drug Group
1 Hydrocodone-Acetaminophen Opioid Analgesics
2 Amoxicillin Penicillins
3 Ibuprofen Anti-inflammatory Analgesics
4 Lisinopril Antihypertensives
5 Omeprazole Ulcer Drugs
6 Azithromycin Macrolides
7 Gabapentin Anticonvulsants
8 Fluticasone Propionate Nasal Agents
9 Metformin HCl Antidiabetics
10 Levothyroxine Sodium Thyroid Agents
11 Cetirizine HCl Antihistamines
12 Montelukast Sodium Antiasthmatic and Bronchodilator Agents
13 ProAir HFA Antiasthmatic and Bronchodilator Agents
14 Amlodipine Besylate Calcium Channel Blockers
15 Albuterol Sulfate Antiasthmatic and Bronchodilator Agents
16 Loratadine Antihistamines
17 Ventolin HFA Antiasthmatic and Bronchodilator Agents
18 Simvastatin Antihyperlipidemics
19 Sertraline HCl Antidepressants
20 Tramadol HCl Opioid Analgesics
21 Oxycodone-Acetaminophen Opioid Analgesics
22 Trazodone HCl Antidepressants
23 Vitamin D (Ergocalciferol) Vitamins
24 Alprazolam Antianxiety Agents
25 Atorvastatin Calcium Antihyperlipidemics
26 Hydrochlorothiazide Diuretics
27 Clonazepam Anticonvulsants
28 Citalopram Hydrobromide Antidepressants
29 Cyclobenzaprine HCl Musculoskelatal Therapy Agents
30 Ranitidine HCl Ulcer Drugs
31 Fluoxetine HCl Antidepressants
32 Amoxicillin-Potassium Clavulanate Penicillins
33 Prednisone Corticosteroids
34 Clonidine HCl Antihypertensives
35 Risperidone Antipsychotics/Antimanic Agents
36 Sulfamethoxazole-Trimethoprim Anti-Infective Agents
37 Cephalexin Cephalosporins
38 Metoprolol Tartrate Beta Blockers
39 Methylphenidate HCl ER ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants
40 Quetiapine Fumarate Antipsychotics/Antimanic Agents
41 Ondansetron HCl Antiemetics
42 Triamcinolone Acetonide Nasal Agents
43 Naproxen Anti-inflammatory Analgesics
44 Vyvanse ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants
45 Furosemide Diuretics
46 Oxycodone HCl Opioid Analgesics
47 Zolpidem Tartrate Hypnotics/Sedatives/Sleep Disorder Agents
48 Aspirin EC Low Dose Nonnarcotic Analgesics
49 Lorazepam Antianxiety Agents
50 Pantoprazole Sodium Ulcer Drugs
Issue Brief Appendix B: Methodology

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