Mail Delays Could Affect Mail-Order Prescriptions for Millions of Medicare Part D and Large Employer Plan Enrollees
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Table 1: Top 10 Therapeutic Classes Filled by Mail Order in Medicare Part D and Large Employer Plans,
by Volume of Prescriptions, 2018 |
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Therapeutic class
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Therapeutic group
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Number of prescriptions filled by mail order
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Number of enrollees with mail-order prescription
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Among all prescriptions filled within therapeutic class, share filled by mail order
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Medicare Part D
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TOTAL, all classes
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114,888,200
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7,293,635
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7.8%
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Antihyperlipidemic Drugs, NEC
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Cardiovascular Agents
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16,517,565
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4,449,520
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14.1%
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Cardiac, Beta Blockers
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Cardiovascular Agents
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8,923,545
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2,552,120
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11.6%
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Cardiac, ACE Inhibitors
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Cardiovascular Agents
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6,934,975
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1,974,120
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12.8%
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Psychotherapeutics, Antidepressants
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Central Nervous System
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6,534,395
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1,659,345
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6.9%
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Cardiac, Calcium Channel
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Cardiovascular Agents
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6,453,380
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1,873,325
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11.3%
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Cardiac Drugs, NEC
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Cardiovascular Agents
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6,021,195
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1,717,620
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13.2%
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Thyroit/Antithyroid, Thyroid/Hormones
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Hormones & Synthetic Substitutes
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5,803,410
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1,561,605
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12.4%
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Gastrointestinal Drug Misc, NEC
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Gastrointestinal Drugs
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5,642,420
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1,700,580
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9.7%
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Antidiabetic Agents, Misc
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Hormones & Synthetic Substitutes
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4,693,630
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1,280,355
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10.8%
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Misc Therapeutic Agents, NEC*
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Misc Therapeutic Agents
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2,984,960
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741,870
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11.7%
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Large Employer Plans
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TOTAL, all classes
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58,076,511
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6,552,568
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9.1%
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Antihyperlipidemic Drugs, NEC
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Cardiovascular Agents
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6,743,934
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1,807,415
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20.1%
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Psychotherapeutics, Antidepressants
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Central Nervous System
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5,723,719
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1,466,376
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10.3%
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Thyroid/Antithyroid, Thyroid Hormones
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Hormones & Synthetic Substitutes
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3,409,575
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897,768
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15.9%
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Cardiac, ACE Inhibitors
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Cardiovascular Agents
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3,185,892
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922,549
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15.6%
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Cardiac, Beta Blockers
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Cardiovascular Agents
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2,680,792
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780,268
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15.5%
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Cardiac Drugs. NEC
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Cardiovascular Agents
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2,574,019
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747,708
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16.1%
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Antidiabetic Agents, Misc
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Hormones & Synthetic Substitutes
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2,512,233
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665,014
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15.0%
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Contraceptive, Oral Comb, NEC
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Hormones & Synthetic Substitutes
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2,411,000
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683,445
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10.3%
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Gastrointestinal Drugs Misc, NEC
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Gastrointestinal Drugs
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2,335,366
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711,485
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13.1%
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Cardiac, Calcium Channel
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Cardiovascular Agents
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2,043,871
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604,578
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14.5%
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NOTE: NEC is not elsewhere classified. Estimates for large employer plans exclude enrollees with fewer than 7 months of coverage. *Less than 1% of prescriptions in the “Misc Therapeutic Agents, NEC” class are categorized in the “Respiratory Tract Agents” therapeutic group.
SOURCE: KFF analysis of IBM Marketscan Commercial Claims and Encounters Database, 2018, and 2018 Medicare prescription drug event claims for a 20 percent sample of Medicare beneficiaries from the CMS Chronic Conditions Data Warehouse.
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| Table 2: Top 10 Drug Products Filled by Mail Order in Medicare Part D and Large Employer Plans, by Volume of Prescriptions, 2018 | |||||
| Drug product | Number of prescriptions filled by mail order | Number of enrollees with mail-order prescription | Among all prescriptions filled for drug product, share filled by mail order | Indication | Common brand names |
| Medicare Part D | |||||
| Atorvastatin calcium | 6,636,765 | 1,967,555 | 13.0% | high cholesterol | Lipitor |
| Levothyroxine sodium | 5,698,630 | 1,548,500 | 12.5% | hypothyroidism | Levothroid, Levoxyl, Synthroid, Unithroid |
| Amlodipine besylate | 4,581,675 | 1,350,760 | 11.2% | hypertension | Katerzia, Norvasc |
| Lisinopril | 4,353,865 | 1,265,540 | 11.7% | hypertension | Prinivil, Zestril |
| Simvastatin | 3,776,125 | 1,089,485 | 16.1% | high cholesterol | Zocor |
| Metformin HCL | 3,696,385 | 1,104,535 | 12.2% | type 2 diabetes | Glucophage |
| Omeprazole | 3,264,810 | 1,004,740 | 11.3% | acid reflux, ulcers, heart burn | Prilosec |
| Losartan potassium | 3,120,395 | 949,995 | 12.6% | hypertension | Cozaar |
| Metoprolol succinate | 2,992,240 | 880,120 | 12.8% | hypertension, angina, heart failure | Kapspargo Sprinkle, Toprol XL |
| Hydrochlorothiazide | 2,288,360 | 690,805 | 13.4% | hypertension | Microzide |
| Large Employer Plans | |||||
| Levothyroxine sodium | 3,072,413 | 837,581 | 16.3% | hypothyroidism | Levothroid, Levoxyl, Synthroid, Unithroid |
| Atorvastatin calcium | 2,858,703 | 864,833 | 18.9% | high cholesterol | Lipitor |
| Lisinopril | 2,067,537 | 608,625 | 15.2% | hypertension | Prinivil, Zestril |
| Metformin HCL | 1,762,022 | 544,089 | 15.5% | type 2 diabetes | Glucophage |
| Amlodipine besylate | 1,349,224 | 407,717 | 13.6% | hypertension | Katerzia, Norvasc |
| Simvastatin | 1,196,826 | 348,014 | 23.1% | high cholesterol | Zocor |
| Losartan potassium | 1,117,641 | 348,870 | 15.3% | hypertension | Cozaar |
| Omeprazole | 1,077,168 | 339,343 | 13.4% | acid reflux, ulcers, heart burn | Prilosec |
| Metoprolol succinate | 965,373 | 281,249 | 16.2% | hypertension, angina, heart failure | Kapspargo Sprinkle, Toprol XL |
| Hydrochlorothiazide | 939,555 | 287,646 | 14.6% | hypertension | Microzide |
| NOTE: Estimates for large employer plans exclude enrollees with fewer than 7 months of coverage. Includes all prescriptions for products containing the specified generic name. Does not reflect combination products that include the active ingredient. Each of the top 10 drugs are available generically. The “common brand names” field is provided as an example of branded versions, though these do not account for all of the mail-order fills for any of these top 10 drug products. SOURCE: KFF analysis of IBM Marketscan Commercial Claims and Encounters Database, 2018, and 2018 Medicare prescription drug event claims for a 20 percent sample of Medicare beneficiaries from the CMS Chronic Conditions Data Warehouse. |
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