OBJECTIVES: To determine whether Medicare Part D coverage of prescription oral chemotherapeutics and a comparative market basket of non-oncologics impacted trends in prescription volume, retail price, and out-of-pocket costs. To assess these trends over the 2005-2008 period, including the January 1, 2006 implementation of Medicare Part D. To investigate geographic trends for states with and without major accredited cancer centers (MACCs). METHODS: The top five prescribed oral chemotherapeutics (capecitabine, imatinib, temozolomide, chlorambucil, cyclophosphamide) and a comparative market basket consisting of the top two prescribed anticonvulsants (clonazepam, gabapentin), antidepressants (escitaprolam, fluoxetine), antipsychotics (quetiapine, risperidone), HIV/AIDS (emtricitabine/tenofovir, ritonavir) and immunosuppressants (azathioprine, mycophenolate) were selected based on total prescriptions (TRx) between January 2005 and April 2008. For that time frame, TRx, average retail price (ARP) and out-of-pocket costs (OPC) per prescription for both Medicare Part D patient and non-Part D Medicare patients were collected. Finally, average TRx and ARP were compared in MACC states versus non-MACC states over that time.  Parameters were collected using the Verispan’s VONA and VOPA databases.  Statistical analyses were performed using one-way ANOVA. RESULTS: Quarterly imatinib TRx increased significantly more than the other chemotherapeutics, >30% between Q1 2005 and Q1 2008 (p<0.05).  This increase was mostly attributable to an increase in refills, which was significantly greater than the other chemotherapeutics (p<0.05). Interestingly, average TRx were significantly higher in MACC states (p<0.05). The ARP significantly increased for capecitabine, imatinib and temozolomide (33% average), while half of the comparative market basket drugs saw an increase in ARP (30% average increase for those 6; p<0.05).  With the exception of imatinib, the average OPC was significantly less for Medicare Part D patients than for non-Part D patients (p<0.05).  Nonetheless, over time, the OPC only increased significantly for capecitabine and for two of the market basket drugs (p<0.05).CONCLUSIONS: The introduction of Medicare Part D did not appear to impact ARP or utilization for the top oral chemotherapeutics. One possible explanation is Medicare Part B coverage of certain oral chemotherapeutics prior to January 1, 2006. Secondly, there may be some drug classes that are more sensitive than others to changes in healthcare policy. We observed a positive correlation between MACC designation with utilization and ARP patterns.