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Expand chart
Data: Centers for Medicare & Medicaid Services; Chart: Harry Stevens/Axios*

Competition doesn't always lead to lower drug prices, at least in the class of drugs administered by a doctor, according to new Medicare payment data. Most of the drugs with the biggest price increases from 2016 to 2017 had at least 2 versions on the market.

Why it matters: This data only captures one year of price changes, but casts doubt on the idea that competition is a foolproof way to constrain drug prices.

Yes, but: Most drugs with more than 5 competing products did see price decreases in 2016.

  • Of the 17 drugs covered by Medicare Part B with more than 10 competing products on the market, just 5 of them — or 29% — saw price increases. And only 35% of the drugs with 6-10 competing products saw a price increase.
  • By contrast, of the 162 drugs with just 1 product on the market, 69%, saw price increases from 2016 to 2017. And of the 125 drugs with 2-5 products, prices increased for 58% of them.
  • This analysis excludes drugs that were used by fewer than than 300 patients. It also doesn't take into account drugs picked up at the pharmacy counter, or price decreases that may have occurred when competition for a drug first entered the market, as it looks at only one year of data.

While some of these drugs cost mere pennies per dosage, each insurance claim can include multiple doses.

  • Insulin delivered through a pump — which had 16 competitors — cost on average $9.45 per dosage in 2017, but the average claim was $958.65.

The bottom line: Drugs with monopoly power aren't the only ones that can raise their prices.

  • Even with competition, "you can’t count on continual price decreases," said Vanderbilt's Stacie Dusetzina after reviewing the data.

*Editor's note: An earlier version of this chart included colistimethate sodium, a drug with 15 beneficiaries in 2017. This chart has been updated to only include drugs with at least 300 beneficiaries in 2017.

Go deeper

Ina Fried, author of Login
19 mins ago - Technology
Column / Signal Boost

Huawei sanctions snarled chip supply chains

Illustration: Sarah Grillo/Axios

The largely successful U.S. effort to hobble China's Huawei has benefitted a host of other tech companies — from smartphone makers such as Apple and Xiaomi to chipmakers like Qualcomm to network vendors including Nokia and Ericsson.

Yes, but: The massive disruption to the industry furthered an industry wide mismatch between supply and demand, exacerbating the global chip shortage.

Tina Reed, author of Vitals
39 mins ago - Health

Overturning Roe could strain abortion access even in blue states

The Supreme Court is reflected in a woman's sunglasses during a march Oct. 2. Photo: Andrew Caballero-Reynolds/AFP via Getty Images

If the Supreme Court overturns Roe v. Wade, abortions could be harder to access even in states where they remain legal, because those clinics could be flooded with patients from states that have cracked down.

The big picture: This has happened before, and clinics fear the crush of demand would be a major problem in the immediate wake of a decision that would allow states to ban abortion.

A critical race theory founder says he's being inundated with threats

Richard Delgado. Photo: Courtesy of Richard Delgado

Richard Delgado, one of the founders of the critical race theory movement, tells Axios he and his wife have been receiving a steady stream of threatening messages since the coordinated, conservative campaign against critical race theory began.

Why it matters: Educators across the country — even some elementary school teachers — have faced harassment and threats over the past year over lesson plans that teach about system racism in the U.S.