Prescription Drugs

Cost or Utilization?
Drivers of
Commercial Prescription Drug Spending

CHIA has released its latest analysis on commercial prescription drug use and spending in an effort to shine a light on the drivers of pharmacy expenditures, including high volume and high-cost drugs. CHIA’s dashboard and detailed dataset, allows users to see drivers of prescription drug spending as well as the associated conditions these drugs treat.

For this analysis, CHIA used commercial pharmacy claims from the agency’s All-Payer Claims Database (APCD) to identify high volume and high-cost drugs between 2018-2022.

Key Findings:

• Overall prescription drug utilization declined as the average cost per prescription increased.
  
  

• Ten therapeutic classes of drugs, which include Immunosuppressants, Hormones & Synthetic Substances, and Cardiovascular Agents, accounted for over 90% of pharmacy expenditures each year.
  
  

• Immunosuppressants, a class of drugs that inhibit immune system activity and are used to treat autoimmune diseases, accounted for the largest portion of spending. The top three drugs by expenditures during the five-year period were Humira, Stelara, and Enbrel, all Immunosuppressants.
  
  

• The most frequently prescribed drugs (i.e., highest volume) during the five-year period were Atorvastatin Calcium and Lisinopril, both Cardiovascular Agents. Atorvastatin Calcium is used to treat high cholesterol and triglyceride levels to reduce the risk of heart and blood vessel problems; Lisinopril is used to treat high blood pressure and heart failure.

For additional information, including the methods and data used to produce this dashboard, see the accompanying technical appendix and dataset.

Commercial Prescription Drug Use and Spending, 2018-2022

Published June 6, 2024

 Updated June 6, 2024