ISSUE: As stakeholders wrestle with policies related to U.S. health care spending, significant attention is paid to the portion of spending attributable to prescription drugs. There are many numbers bandied about, ranging from 10.1% to 27.7%. The vast range of these estimates, however, renders them useless for the ongoing health care spending discussion. If stakeholders are unable to agree on a number, how can they even begin to agree on a policy?

Sean Keehan will take the perspective of a government agency seeking to quantify health care spending for the entire U.S. population. The CMS estimate is 10.1%. Cynthia Cox will take the perspective of a policy analysis group seeking to estimate health care spending for those with health insurance coverage through a large employer. The KFF estimate is 21.0%. Sara Sadownik will take the perspective of an individual U.S. state seeking to understand their state’s health care spending trends. The MHPC estimate is 17.0%. Michael Kleinrock will share the health plan perspective, using AHIP’s estimates of 22.0% and 27.7%, and, as moderator, will facilitate the exploration of these differing perspectives and their resultant discordant estimates of the share of the health care dollar attributable to drugs, and provide a bridge to reconcile the differences where possible.

OVERVIEW: Many policy discussions on health care spending are focusing on controlling the share of health care spending allocated to prescription drugs. However, estimates of this share stem from very different research questions and can vary considerably from each other. Informed policy discussions require a mutual understanding of the data and an estimate that is relevant to both the research and policy questions at hand. This panel will debate how the share of health care spending attributable to drugs should be measured and whether there is a “right” number for policy discussions.