ライフサイエンスコーパス: Medicare

1 .3% in MarketScan and from 12.6% to 45.1% in Medicare).

2 cription drug prices could decrease costs to Medicare.

3 ean [SD] age, 64 [15] years), 48% (n = 3631) Medicare, 48% (n = 3667) privately insured, and 4% (n =

4 ts for future health policy interventions in Medicare, a contemporary appraisal of its epidemiology a

5 o rising Medicare costs, Congress passed the Medicare Access and Children's Health Insurance Program

6 The implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) off

7 To analyze the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MA

8 horacic Surgeons National Database linked to Medicare administrative claims for follow-up, 9,464 prop

9 Here, we use Medicare administrative data to examine the association

10 l be reimbursed at the discretion of a local Medicare administrator, if deemed medically necessary.

11 Of 1818873 Medicare admissions treated by general internists, 38475

12 rehouse of privately insured individuals and Medicare Advantage enrollees.

13 roprietary, integrated database and included Medicare and commercial insurance enrollees with a new,

14 rval, 7-24%; P < 0.001) absolute increase in Medicare and Medicaid (from 33%).

15 nfections (SSIs) are used by the Centers for Medicare and Medicaid Services (CMS) as pay-for-performa

16 for stewardship programs by the Centers for Medicare and Medicaid Services (CMS).

17 hospital reimbursement from the Centers for Medicare and Medicaid Services (CMS).

18 were linked to patient-specific Centers for Medicare and Medicaid Services administrative claims for

19 The Center for Medicare and Medicaid Services adopted the Early Managem

20 zation and Payment Data from the Centers for Medicare and Medicaid Services among fee-for-service (FF

21 The Centers for Medicare and Medicaid Services coverage includes 3 postt

22 Center for Medicare and Medicaid Services data were used to calcula

23 Centers for Medicare and Medicaid Services definitions of an "eligib

24 federal exchange plans from the Centers for Medicare and Medicaid Services for the 2016 enrollment y

25 by The Joint Commission, and the Centers for Medicare and Medicaid Services has proposed a similar re

26 bypass grafting (STS-CABG), and Centers for Medicare and Medicaid Services Hospital Consumer Assessm

27 We divided the Centers for Medicare and Medicaid Services hospital-wide readmission

28 Centers for Medicare and Medicaid Services inpatient claims data and

29 Among the patients with Centers for Medicare and Medicaid Services linkage data, the mortali

30 ork, with ESRD ascertainment via Centers for Medicare and Medicaid Services linkage, using Cox regres

31 The Centers for Medicare and Medicaid Services Medicare Part D Prescribe

32 RATIONALE: The Centers for Medicare and Medicaid Services recently implemented fina

33 to manufacturers that resulted in Center for Medicare and Medicaid Services stating that the use of m

34 Act of 2008, which directed the Centers for Medicare and Medicaid Services to expand the payment bun

35 The Centers for Medicare and Medicaid Services will evaluate provider co

36 mong participants with available Centers for Medicare and Medicaid Services-linked data.

37 nd redesign of payments from the Centers for Medicare and Medicaid Services.

38 care bed supply using data from Centers for Medicare and Medicaid Services.

39 history of HF and were receiving Centers for Medicare and Medicaid Services.

40 gnificant expansion of health coverage since Medicare and Medicaid were enacted.

41 f proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as

42 Linked Medicare and National Death Index data from 1984 to 2010

43 llance, Epidemiology, and End Results (SEER)-Medicare and NLST datasets for patients with stage 1 dis

44 home dialysis, which were identical for both Medicare and non-Medicare patients.

45 e insurance (OR, 0.90; 95% CI, 0.85-0.95 for Medicare and OR, 0.73; 95% CI, 0.65-0.82 for Medicaid).

46 Total and potential Medicare and out-of-pocket patient spending.

47 There has been a sharp increase in Medicare and out-of-pocket spending on topical steroids

48 To characterize Medicare and patient out-of-pocket costs for topical ste

49 to 72.0% in MarketScan and 21.1% to 58.8% in Medicare) and those taking low- or moderate-intensity st

50 donor kidney transplantation recipients with Medicare as primary payer from 2000 to 2008.

51 Main outcome measures were spending by Medicare as tracked by Current Procedural Terminology co

52 pitals) from 0.42+/-0.01% to 0.89+/-0.01% of Medicare base diagnosis-related-group payments.

53 The authors identified 90,869 Medicare beneficiaries >/=65 years of age who had prescr

54 a cohort of 2 331 939 unique fee-for-service Medicare beneficiaries >/=65-years-old followed for all

55 In a cohort of 18.9 million Medicare beneficiaries (4.2 million deaths) living acros

56 Medicare beneficiaries 65 years old or older admitted fo

57 on, and persistence after reinitiation among Medicare beneficiaries after hospital discharge for a my

58 stry, we assessed the incidence of AKI among Medicare beneficiaries after PCI from 2004 to 2009 and s

59 Medicare beneficiaries aged 66 to 75 years (n = 29932) a

60 lant, we performed a cohort study of 469,574 Medicare beneficiaries ages >/=50 years old who received

61 creased by 5.8% (95% CI, 4.3% to 6.9%) among Medicare beneficiaries and 4.1% (95% CI, 2.3% to 5.4%) a

62 U.S. fee-for-service Medicare beneficiaries and Oklahoma ophthalmologist and

63 METHODS AND Elderly (aged >/=66 years) Medicare beneficiaries enrolled in Medicare Part D benef

64 METHODS AND In a national 5% sample of Medicare beneficiaries from 2002 to 2013, we identified

65 dical and pharmacy claims of a 20% sample of Medicare beneficiaries from 2006 to 2013 and compared ra

66 edicaid Services among fee-for-service (FFS) Medicare beneficiaries from 2012 to 2015; 2008 claims we

67 We identified 12,420 Medicare beneficiaries from the National Cardiovascular

68 tory files (2002-2006), including 28 million Medicare beneficiaries in 708 counties.

69 ionalized community, and the NHATS comprised Medicare beneficiaries in the contiguous United States.

70 Among the 68374904 unique Medicare beneficiaries in the study, there were 469582 h

71 We conducted a retrospective cohort study of Medicare beneficiaries linked to laboratory data in 10 s

72 1, 2014, for a random 5% sample of 1 618 059 Medicare beneficiaries older than 66 years.

73 ubstantial changes in intended management in Medicare beneficiaries participating in the National Onc

74 More than 20% of Medicare beneficiaries receiving cardiac resynchronizati

75 Among hospitalized Medicare beneficiaries treated by a general internist, t

76 quality and costs of care among hospitalized Medicare beneficiaries treated by locum tenens vs non-lo

77 gation was a cross-sectional cohort study of Medicare beneficiaries undergoing colectomy (189229 pati

78 Among Medicare beneficiaries undergoing gastric band surgery,

79 A population-based study was conducted of Medicare beneficiaries undergoing laparoscopic or open c

80 bstantiated by a representative sample of US Medicare beneficiaries using self-reported visual functi

81 initial therapy for neovascular AMD among US Medicare beneficiaries varied substantially across geogr

82 Results Of the 1.2 million fee-for-service Medicare beneficiaries who developed prostate cancer in

83 A retrospective review 5,122,240 Medicare beneficiaries who underwent future targeted pro

84 easure out-of-pocket (OOP) costs incurred by Medicare beneficiaries with cancer and identify which fa

85 Medicare beneficiaries with cancer are at risk for finan

86 Participants were Medicare beneficiaries with cancer who received care at

87 Of 10 443 Medicare beneficiaries with heart failure started on an

88 Conclusion Medicare beneficiaries with myeloma who do not receive L

89 tion for propensity-score matched cohorts of Medicare beneficiaries with PAD from 2006 through 2009.

90 Among 65,747 Medicare beneficiaries with pneumonia who required mecha

91 (MI), CHD events, and all-cause mortality in Medicare beneficiaries with statin intolerance and in th

92 Medicare beneficiaries without supplemental insurance in

93 In a nationally representative sample of Medicare beneficiaries, cirrhosis was associated with an

94 ed survey data from 18166 community-dwelling Medicare beneficiaries, including 1409 individuals who w

95 Among hospitalizations for US Medicare beneficiaries, major teaching hospital status w

96 Although screening is covered for eligible Medicare beneficiaries, the generalizability of the NLST

97 Among fee-for-service Medicare beneficiaries, the performance of carotid endar

98 tantial changes in the epidemiology of HF in Medicare beneficiaries, with a decline in incident HF an

99 ovel TOAMs to increase price competition for Medicare beneficiaries.

100 ocardial infarction (AMI) are calculated for Medicare beneficiaries.

101 age-related macular degeneration (AMD) among Medicare beneficiaries.

102 is concentrated among a subset of high-cost Medicare beneficiaries.

103 across distinct subpopulations of high-cost Medicare beneficiaries.

104 nstitute's 45 and Up cohort study, linked to Medicare Benefits Schedule claims data, the cancer regis

105 Cancer diagnoses were identified using Medicare billing codes and categorized as nonmelanoma sk

106 ffects suggest that major payment changes in Medicare can affect all patients with ESRD.

107 stimated that no more than 0.47% of all 2014 Medicare Cardiac ICU admissions were treated by a dual-b

108 Medicare-certified nursing homes in the USA located with

109 We classified NOPR NaF PET results linked to Medicare claims by imaging indication (initial staging [

110 Using 100% Texas Medicare Claims Data from 2006 to 2011, we identified pa

111 cohort study using inpatient and outpatient Medicare claims data from January 1, 2008, through Decem

112 cted a retrospective cohort study using U.S. Medicare claims data from patients undergoing pulmonary

113 anscatheter Valve Therapy Registry linked to Medicare claims data, we identified patients >/=65 years

114 rable controls aged > 65 years in 2009 using Medicare claims data.

115 t beneficiaries age 67 years or older in the Medicare claims database was assessed to determine the u

116 laims were acquired from the 100% FFS Part B Medicare Claims File.

117 We used Medicare claims from 2011 through 2013 to evaluate the n

118 Fee-for-service Medicare claims from January 1, 2009, to December 31, 20

119 uary 1, 1999 to December 31, 2011) linked to Medicare claims through the US Renal Data System.

120 United States Renal Data System data set to Medicare claims to estimate cumulative costs, graft surv

121 ld from the US Renal Data System with linked Medicare claims to identify the first predialysis vascul

122 Medicare claims were used to assess patterns of hospice

123 cordance with clinical actions inferred from Medicare claims.

124 74, 75 to 79, and >/=80 years of age) using Medicare claims.

125 tabase of licensed U.S. physicians linked to Medicare claims.

126 oved to 0.721 (95% CI, 0.711-0.730) when the Medicare cohort was used to recalibrate the beta coeffic

127 EER population and 79 (6) years for the SEER-Medicare cohort.

128 Total costs to Medicare, components of cost, and resource use (emergenc

129 compare quarterly changes in the mean total Medicare costs and resource use between navigated patien

130 In response to rising Medicare costs, Congress passed the Medicare Access and

131 o 2012 with at least 13 months of continuous Medicare coverage before death.

132 sion of transsexual surgical treatments from Medicare coverage was based on outdated, incomplete, and

133 With Medicare coverage, monitoring incurs budgetary expenditu

134 Methods We used SEER-Medicare data for elderly patients with a new diagnosis

135 The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up.

136 Methods We used SEER-Medicare data from 2005 to 2013 to compare outcomes of A

137 We used national Medicare data to identify beneficiaries who underwent 1

138 We used Medicare data to investigate HZV effectiveness (VE) and

139 Medicare data were retrospectively obtained for particip

140 llance, Epidemiology, and End Results (SEER)-Medicare data, a population-based study of men diagnosed

141 ents and Methods Using Texas Cancer Registry-Medicare data, we assessed patients with ovarian cancer

142 Patients and Methods Using 2004 to 2009 SEER-Medicare data, we exploited a natural experiment to exam

143 Methods Using SEER-Medicare data, we identified Part D beneficiaries diagno

144 h the Guidelines Heart Failure registry with Medicare data.

145 llance, Epidemiology, and End-Results (SEER)-Medicare database.

146 Of 2868 hospitals serving 1 109 530 Medicare discharges annually, 30.1% were highest perform

147 Medicare eligibility was associated with an abrupt 6.4 (

148 rable cardiovascular health (P<0.001) during Medicare eligibility.

149 Participants included 5888 Medicare-eligible individuals 65 years or older who were

150 tched by demographics and comorbidities to a Medicare enrollee without cancer, and each pair was foll

151 acture hospital admissions among 9.2 million Medicare enrollees of the Northeast/Mid-Atlantic United

152 Among elderly Medicare enrollees, the risk for interval CRC was higher

153 roscopic colectomy (vs open) still had lower Medicare expenditures (mean, -$3676; 95% CI, -$2444 to -

154 To evaluate the differences in Medicare expenditures for laparoscopic and open colectom

155 nrolled in hospice, in-home death, and total Medicare expenditures in the 6 months before death.

156 en body mass index (BMI) and hospice use and Medicare expenditures in the last 6 months of life.

157 , -6.0 to -0.4 percentage points), and total Medicare expenditures increased by $3471 (CI, $955 to $5

158 e illness, but its effect on hospice use and Medicare expenditures is unknown.

159 th was 61.3% (CI, 59.4% to 63.2%), and total Medicare expenditures were $42 803 (CI, $41 085 to $44 5

160 Retrospective study of Medicare fee-for-service beneficiaries aged 65 years or

161 Serial cross-sectional analysis of Medicare fee-for-service beneficiaries aged 65 years or

162 We studied all Medicare fee-for-service beneficiaries between 1999 and

163 A random sample of Medicare fee-for-service beneficiaries hospitalized duri

164 Among Medicare fee-for-service beneficiaries hospitalized for

165 Between 1999 and 2013, among Medicare fee-for-service beneficiaries, patients were ho

166 S AND We performed a descriptive analysis of Medicare fee-for-service beneficiaries, with at least on

167 "high-cost" patients, using a 20% sample of Medicare fee-for-service claims from 2012.

168 On the basis of Medicare fee-for-service claims, the incidence of respir

169 Beneficiaries had Medicare fee-for-service coverage including pharmacy ben

170 lth insurance (ie, those who were considered Medicare fee-for-service).

171 more successful existing programs, such as a Medicare for All.

172 he annual cost for 10 common conditions from Medicare had lower Q5:Q1 ratios that ranged from 1.33 (j

173 rs had the lowest approval rates (24.4%) and Medicare had the highest (60.9%).

174 To this end, Medicare has sponsored pilot projects to encourage provi

175 v 1, 2013, and May 31, 2014, identified from Medicare hospital claims available for residents who wer

176 he greatest improvement after passage of the Medicare Hospital Readmissions Reduction Program (HRRP)

177 ospective payment system and mandated by the Medicare Improvements for Patients and Providers Act of

178 ophthalmologists submitting fewer charges to Medicare in 2012 (median, 1120 charges; difference -935;

179 5 years or older from 1999 to 2014 using the Medicare Inpatient and Denominator files.

180 rformed a retrospective analysis of the 100% Medicare inpatient claims file, from January 1, 2008, to

181 nterquartile range 2.0-5.0) days, but median Medicare inpatient expenditure per beneficiary increased

182 d United States Renal Data System records of Medicare-insured kidney transplant recipients in 2000 to

183 By using the Medicare Limited 5% dataset, there was no difference in

184 The 2010 to 2012 Medicare Limited Data Set was used to develop risk-adjus

185 We used United States Renal Data System Medicare-linked data on patients waitlisted between 2005

186 lized patients with HFpEF (EF >/=50%) in the Medicare-linked OPTIMIZE-HF (Organized Program to Initia

187 We obtained data from the Centers for Medicare & Medicaid Services (CMS) and enrolled faciliti

188 ected in reimbursements from the Centers for Medicare & Medicaid Services (CMS) to ophthalmologists,

189 and/or rural designation in the Centers for Medicare & Medicaid Services ambulance fee schedule by z

190 veloped by Million Hearts and the Center for Medicare & Medicaid Services as a strategy to assess a v

191 it, and serves as the basis for a Center for Medicare & Medicaid Services program designed to evaluat

192 ospital characteristics (average Centers for Medicare & Medicaid Services-hierarchical condition cate

193 egistry linked to administrative claims from Medicare, Medicaid, and private insurance.

194 is and surgery for melanoma in patients with Medicare, Medicaid, or private insurance.

195 patients (OR 0.52, P < 0.01) and those with Medicare/Medicaid (OR 0.79, P < 0.01) were less likely t

196 ins with high adherence, and those with dual Medicare/Medicaid coverage and more cardiologist visits

197 Sociodemographic, dual Medicare/Medicaid coverage, comorbidities, not filling h

198 lated hospitalization rates constructed from Medicare National Claims History files (2002-2006), incl

199 If Medicare negotiated the prices for ophthalmic medication

200 All patients with Medicare or Medicaid coverage and all uninsured patients

201 During the study period, Medicare paid $470 million for laparoscopic gastric band

202 retrospective analysis of publicly available Medicare Part B claims data from January 2012 to Decembe

203 er 1000 beneficiaries per year, P=0.02), and Medicare Part B expenditures ($37 more per beneficiary p

204 department visits, inpatient admissions, and Medicare Part B expenditures.

205 Medicare Part B National Summary Data Files for calendar

206 d neck, genitalia, hands, and feet region of Medicare Part B patients.

207 Medicare Part B reimbursement for ophthalmologists was p

208 In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8

209 Secondary outcomes included inpatient Medicare Part B spending, length of stay, and 30-day rea

210 Medicare Part D 2013 prescriber public use file and summ

211 and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on pati

212 ly lowers out-of-pocket costs for qualifying Medicare Part D beneficiaries who receive orally adminis

213 66 years) Medicare beneficiaries enrolled in Medicare Part D benefit plan from November 2011 to Octob

214 ed the impact of closing the coverage gap in Medicare Part D in 2020.

215 neric and branded drugs from 2011 to 2015 by Medicare Part D participants who filled prescriptions fo

216 physicians were analyzed using 2013 to 2015 Medicare Part D Prescriber Data.

217 udy was a retrospective cost analysis of the Medicare Part D Prescriber Public Use File, which detail

218 e Centers for Medicare and Medicaid Services Medicare Part D Prescriber Public Use Files for 2013, 20

219 To quantify costs of eye care providers' Medicare Part D prescribing patterns for ophthalmic medi

220 roviders accounted for $2.4 billion in total Medicare part D prescription drug costs and generated th

221 Methods Using SEER linked to Medicare Part D, 2007 to 2012, we identified patients wh

222 Acute care, Medicare participating hospitals from 2008 to 2011.

223 2005 and 2013 with continuous enrollment in Medicare parts A and B (n = 53 810) to examine the assoc

224 stage I or II breast cancer, and enrolled in Medicare Parts A, B, and D during 2007 to 2011.

225 study was a retrospective analysis of 28018 Medicare patients 65 years or older admitted with NSTEMI

226 nstruct a network defined by the transfer of Medicare patients across US inpatient facilities using a

227 examine whether risk for interval CRC among Medicare patients differs by race/ethnicity and whether

228 Retrospective cohort study of Medicare patients following hospitalization for myocardi

229 ayment that a dialysis facility receives for Medicare patients on dialysis to the facility's performa

230 isual-field monitoring system among eligible Medicare patients was performed.

231 ardized 30-day readmissions and mortality in Medicare patients.

232 among recently hospitalized patients versus Medicare patients.

233 ich were identical for both Medicare and non-Medicare patients.

234 ered by Medicaid payers, and 1854 covered by Medicare payers were identified between 2003 and 2013.

235 care coverage from commercial, Medicaid, and Medicare payers.

236 asure would increase penalties (mean [+/-SE] Medicare payment reductions across all hospitals) from 0

237 ethods to account for selection bias, actual Medicare payments after each procedure were evaluated.

238 ferences in Medicare spending, risk-adjusted Medicare payments for an episode of surgical care were s

239 er 2014 includes all physicians who received Medicare payments for MMS from any practice performing M

240 ospitals are held accountable for nearly all Medicare payments that occur during the initial hospital

241 included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medica

242 reimbursement represented 32.8% of the total Medicare payments to ophthalmologists.

243 ariation in Medicare spending, risk-adjusted Medicare payments were not statistically different betwe

244 Risk-adjusted 30-day Medicare payments were price-standardized to account for

245 ionship between hospital teaching intensity, Medicare payments, and perioperative outcomes.

246 Materials and Methods This study used the Medicare Physician and Other Supplier Public Use File an

247 During the first year of the Medicare Physician Value-Based Payment Modifier Program,

248 on and payment of ophthalmic services in the Medicare population for years 2012 and 2013.

249 All-cause mortality in the entire Medicare population from 2000 to 2012.

250 The study included the entire Medicare population from January 1, 2000, to December 31

251 Despite making up only 4% of the Medicare population, high-cost frail elderly persons acc

252 In the entire Medicare population, there was significant evidence of a

253 o that for capping and abandoning leads in a Medicare population.

254 sion compared with Medicaid/no insurance and Medicare populations.

255 awing on a 22-center cohort, 379 ILDKTs with Medicare primary insurance were matched to compatible tr

256 national registry data to study 56 076 adult Medicare-primary first-time kidney transplant recipients

257 The Medicare program, however, reimburses screening colonosc

258 Medicare program.

259 Costs were converted to Medicare proportional dollars (MP$).

260 Medicare Provider Analysis and Review data contain robus

261 anuary 1, 2009, and December 1, 2009, in the Medicare Provider Analysis and Review database.

262 The Medicare Provider Analysis and Review procedure codes fo

263 ither an ICU or coronary care unit charge in Medicare Provider Analysis and Review.

264 mes dataset, 80.1% were matched with data in Medicare Provider Analysis and Review.

265 Using Medicare Provider and Analysis Review files, we studied

266 These claims were identified from the Medicare Provider Utilization and Payment Data from the

267 Medicare recently approved coverage of home telemonitori

268 Medicare recently launched the Physician Value-Based Pay

269 All the patients in the cohort were Medicare recipients who were at least 65 years of age.

270 Medicare reform proposals that restructure the benefit d

271 dical services provided, and the most common Medicare-reimbursed ophthalmic services.

272 levels using the ratio of hospital costs to Medicare reimbursement and categorized into major cost c

273 he primary outcome was 30-day mortality with Medicare reimbursement as a secondary outcome.

274 ting system costs were normalized to reflect Medicare reimbursement levels using the ratio of hospita

275 Hospital costs were estimated using Medicare reimbursement rates for 2013.

276 calculated on the basis of resource use and Medicare reimbursement rates.

277 d clinical volume measured according to 2013 Medicare reimbursement.

278 ursement represented only a small portion of Medicare reimbursement.

279 performance-based adjustments of up to 1% to Medicare reimbursements for acute care hospitals.

280 these, if successful, will help ensure that Medicare remains solvent in coming years.

281 521 and 3751 YAG laser capsulotomy claims to Medicare, respectively.

282 Using the 5% Medicare sample, we identified patients with de novo car

283 To compare patient and Medicare savings from the use of optical coherence tomog

284 reimbursement by the Centers for Medicaid & Medicare Services.

285 e care organization (ACO) performance in the Medicare Shared Savings Program (MSSP) focus on disease

286 ACOs) on use of screening mammography in the Medicare Shared Savings Program (MSSP), the largest valu

287 but was associated with significantly lower Medicare spending ($18,433 vs $27,051; p = 0.02).

288 ation to account for intended differences in Medicare spending, risk-adjusted Medicare payments for a

289 r social subsidies and regional variation in Medicare spending, risk-adjusted Medicare payments were

290 long with modest gains in survival and total Medicare spending.

291 tentially preventable spending varied across Medicare subpopulations, with the majority concentrated

292 efibrillators identified from commercial and Medicare supplemental claims databases linked to adjudic

293 rcial insurance and 96 days in patients with Medicare Supplemental insurance.

294 ng administrative claims from commercial and Medicare Supplemental plans (2001-2014), we compared ris

295 mmercial plans; 8 per 1000 among patients in Medicare Supplemental plans).

296 r 1000, -0.08; 95% CI, -0.51 to 0.36) or the Medicare Supplemental population (weighted RD per 1000,

297 were stratified by plan type (commercial vs Medicare Supplemental).

298 mately, 64% went through the acute inpatient Medicare system without record of anything untoward.

299 For patients enrolled in Medicare, the corresponding total out-of-pocket cost wil

300 Policy changes enabling Medicare to negotiate prescription drug prices could dec