TABLE 3.
Sociodemographic and Spending Characteristics of Part D Beneficiaries Taking Each Drug Facing Price Negotiations (2020)
| Apixaban (Eliquis) | Rivaroxaban (Xarelto) | Sitagliptin (Januvia) | Insulin aspart (Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill) | Ibrutinib (Imbruvica) | Empagliflozin (Jardiance) | Etanercept (Enbrel) | Sacubitril and val-sartan (Entresto) | Ustekinumab (Stelara) | Dapagliflozin (Farxiga) | |
|---|---|---|---|---|---|---|---|---|---|---|
| Mean age (SD) | 76.8 (9.7) | 75.0 (9.9) | 72.6 (10.0) | 69.0 (11.7) | 75.7 (8.3) | 68.9 (9.0) | 67.2 (10.9) | 72.3 (10.5) | 61.5 (14.2) | 68.6 (9.6) |
| Sex, % | ||||||||||
| Female | 53.0 | 50.6 | 54.6 | 54.8 | 41.1 | 45.8 | 71.4 | 35.8 | 59.0 | 47.6 |
| Male | 47.0 | 49.4 | 45.4 | 45.2 | 58.9 | 54.2 | 28.6 | 64.2 | 41.0 | 52.4 |
| Race, % | ||||||||||
| White | 84.0 | 83.7 | 67.0 | 69.3 | 84.6 | 70.7 | 75.4 | 73.3 | 79.5 | 70.6 |
| Black | 9.4 | 8.8 | 15.6 | 18.3 | 9.2 | 12.6 | 10.9 | 17.9 | 9.9 | 13.0 |
| Othera | 6.6 | 7.5 | 17.4 | 12.4 | 6.2 | 16.7 | 13.7 | 8.8 | 10.6 | 16.3 |
| Zip code median household income, % | ||||||||||
| <$25,000 | 0.9 | 1.2 | 1.9 | 1.1 | 0.8 | 1.3 | 1.8 | 1.0 | 1.4 | 1.6 |
| $25,000 - <$50,000 | 24.5 | 23.5 | 30.1 | 32.6 | 20.6 | 28.3 | 26.4 | 30.9 | 23.9 | 30.1 |
| $50,000 - <$75,000 | 41.6 | 41.5 | 40.1 | 43.0 | 40.9 | 41.1 | 39.9 | 40.3 | 41.9 | 40.9 |
| $75,000 - <$100,000 | 19.8 | 20.2 | 17.4 | 15.3 | 21.4 | 18.1 | 19.3 | 17.5 | 20.4 | 17.3 |
| >$100,000 | 13.2 | 13.6 | 10.6 | 7.9 | 16.3 | 11.2 | 12.6 | 10.4 | 12.3 | 10.1 |
| Type of locality, % | ||||||||||
| Urban | 80.2 | 80.4 | 81.9 | 77.4 | 81.1 | 81.0 | 80.2 | 80.6 | 80.3 | 78.6 |
| Suburban | 16.1 | 15.9 | 14.9 | 18.4 | 14.9 | 15.7 | 16.0 | 16.2 | 16.6 | 17.6 |
| Rural | 3.7 | 3.7 | 3.2 | 4.2 | 4.0 | 3.3 | 3.8 | 3.2 | 3.1 | 3.7 |
| Mean number of comorbidities per beneficiary (SD) | 4.3 (4.3) | 3.9 (4.0) | 3.4 (3.8) | 4.9 (4.4) | 3.4 (3.7) | 3.1 (3.5) | 2.6 (3.2) | 4.4 (4.4) | 2.6 (3.1) | 3.7 (3.6) |
| Medicare Advantage, % | 48.9 | 48.2 | 56.4 | 46.0 | 44.9 | 57.0 | 55.9 | 51.9 | 48.9 | 47.0 |
| Mean (median) annual spending per beneficiaryb | ||||||||||
| Medicare Part D | $9,461 ($6,106) | $9,847 ($6,203) | $11,364 ($7,598) | $15,467 ($10,105) | $117,692 ($127,878) | $13,898 ($9,739) | $59,796 ($63,107) | $11,729 ($8,025) | $99,255 ($80,839) | $14,637 ($10,735) |
| Hospital | $12,616 ($0) | $9,180 ($0) | $6,847 ($0) | $13,939 ($0) | $9,927 ($0) | $4,777 ($0) | $3,602 ($0) | $14,010 ($0) | $6,292 ($0) | $5,184 ($0) |
| Outpatient | $13,464 ($6,373) | $11,656 ($5,474) | $8,714 ($3,533) | $16,312 ($7,636) | $17,937 ($7,963) | $7,664 ($3,347) | $7,021 ($3,257) | $14,137 ($6,743) | $13,754 ($5,666) | $7,744 ($3,239) |
| Totalc | $35,850 ($19,138) | $30,897 ($16,699) | $27,517 ($15,327) | $46,014 ($28,530) | $147,273 ($160,919) | $26,932 ($17,421) | $71,092 ($70,307) | $40,313 ($24,007) | $123,514 ($104,395) | $28,383 ($18,305) |
| Mean (median) Part D annual out-of-pocket costsd | $900 (553) | $872 (492) | $652 (168) | $634 (111) | $4,824 (3,794) | $820 (220) | $833 (55) | $934 (439) | $873 (32) | $748 (176) |
aOther includes Hispanic, Asian, North American Native, Other, and Unknown racial categories.
bMedicare program spending only. Hospital, outpatient, and total costs exclude beneficiaries with Medicare Advantage, for whom that spending data are not available. Medians are shown instead of SDs because of right-tailed distribution.
cThese totals exclude skilled nursing facility and durable medical equipment spending.
dRepresents total annual Part D out-of-pocket spending on any drug claims for beneficiaries using each negotiated drug.