THE DERIVATION OF TRICARE SPECIFIC CONSUMER PRICE INDICES FOR PRESCRIPTION DRUGS

Author(s)

Summers CRTRICARE Management Activity, Falls Church, VA, USA

Objective: One of the chronic issues in pharmaceutical utilization management is the dearth of accurate price benchmarks available to establish pharmacy-pricing performance.  This paucity of appropriate benchmarks is further complicated for organizations, such as TRICARE, who have reason to believe that their demographics and hence disease profiles yield atypical prescription drug market baskets.  Thus, to obtain an accurate assessment of organizational performance, organization-specific indices need to be developed. Method: A unique approach to developing organization specific benchmarks is underway in a joint venture between the TRICARE Pharmaceutical Operations Directorate (POD) and the US Bureau of Labor Statistics (BLS).  The primary method is to match retail pricing information provided by BLS and portfolio information provided by TRICARE to construct organization specific benchmarks that can be tracked over time. Variables from the Consumer Price Index for Prescription Drugs (CPI-Rx) are transferred to the POD as specified in an intergovernmental memorandum of understanding.  To form an overall TRICARE-Rx index for a specific month, all TRICARE prescription data are aggregated by specific drug and the number of prescriptions is computed for each drug for specific month using a file extracted from the Pharmacy Data Transaction Service (PDTS).  CPI-Rx prices are then aggregated by same list of unique drugs used in the TRICARE sample then averaged in a separate file.  The files are then merged using NDC codes as the key.  The index is computed using the average CPI-Rx price for each specific drug multiplied by the TRICARE N for the corresponding drugs then averaged. Implications:  TRICARE spends roughly $7.5 Billion annually for prescription drugs.  With the development of these indices, we can better gauge our cost containment priorities and efforts.  This will help us determine if increases in costs are due to general drug price inflation specific to our unique market basket of drugs.

Conference/Value in Health Info

2010-05, ISPOR 2010, Atlanta, GA, USA

Value in Health, Vol. 13, No. 3 (May 2010)

Code

PMC4

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Multiple Diseases

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