High payment per monthly supply of medication underlies the high total of neurology drug payments, with multiple sclerosis drugs leading the way, according to a recent study. Using the 2013 Medicare Part D Prescriber Public Use and Summary files, researchers examined neurologists’ prescribing patterns and the potential effect of generic drug substitutions and price negotiation, which is currently prohibited. They found:

• Neurologists comprised 13,060 (1.2%) providers with $5.0 billion (4.8%) in total payments, the third highest of all specialties.

• Multiple sclerosis drugs had the highest payments ($1.8 billion).

• Within neurological disease groups ($3.4 billion in payments), 54.2% to 91.8% of monthly supplies were generic, but 11.9 % to 71.3% of the payment was earmarked for generic medications.

• Generic substitutions resulted in a $269 million (6.5%) payment decrease.

• VA pricing resulted in $1.5 billion (44.5% of $3.4 billion) in savings.

Citation: De Lott L, Burke, J, Krber K, Skolarus L, Callaghan B. Medicare Part D payments for neurologist-prescribed drugs. [Published online ahead of print March 18, 2016]. Neurology. doi:10.1212/WNL.0000000000002589.