Report to Congressional Requesters

United States Government Accountability Office

GAO

August 2005 PRESCRIPTION 

DRUGS 

Price Trends for 

Frequently Used 

Brand and Generic 

Drugs from 2000 

through 2004 

GAO-05-779 
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

www.gao.gov/cgi-bin/getrpt?GAO-05-779.

To view the full product, including the scope 

and methodology, click on the link above. 

For more information, contact Marjorie Kanof 

at (202) 512-7114 or kanofm@gao.gov. 

Highlights of GAO-05-779, a report to 

congressional requesters 

August 2005

PRESCRIPTION DRUGS 

Price Trends for Frequently Used Brand 

and Generic Drugs from 2000 through 

2004 

We found the average U&C prices at retail pharmacies reported by two state 

pharmacy assistance programs for a 30-day supply of 96 drugs frequently 

used by BCBS FEP Medicare and non-Medicare enrollees increased 

24.5 percent from January 2000 through December 2004. Of the 96 drugs: 

• Twenty drugs accounted for nearly two-thirds of the increase in the U&C 

price index. 

• The increase in average U&C prices for 75 prescription drugs frequently 

used by Medicare beneficiaries was similar to the increase for 76 

prescription drugs frequently used by non-Medicare enrollees. 

• The average U&C prices for 50 frequently used brand prescription drugs 

increased three times as much as the average for 46 generic frequently 

used prescription drugs. 

AWPs increased at a faster rate than AMPs and U&C prices for the 50 

frequently used brand drugs from first quarter 2000 through fourth quarter 

2004. Ten drugs in each index accounted for almost 50 percent of the 

increase for AMP, AWP, and U&C prices. Eight of these 10 drugs were 

consistent across the three price indexes. 

The Centers for Medicare & Medicaid Services (CMS), two state pharmacy 

assistance programs, and BCBS FEP reviewed a draft of this report. While 

CMS noted that U&C and AWP do not reflect discounts in a drug’s price, this 

report’s focus was to examine price trends rather than price levels. 

Technical comments were incorporated as appropriate. 

Average Annual Percentage Change of AMP, AWP, and U&C Price Indexes for 50 Brand 

Drugs Frequently Used by Enrollees in BCBS FEP, from First Quarter 2000 through Last 

Quarter 2004 

Percentage change

Source: GAO analysis of data from CMS, First DataBank, New York’s Elderly Pharmaceutical Insurance Coverage

program, Pennsylvania’s Pharmaceutical Assistance Contract for the Elderly program, and BCBS FEP. 

0

1

2

3

4

5

6

5.4

6.0

5.2

AMP AWP U&C

Prescription drug spending has 

been the fastest growing segment 

of national health expenditures. As 

the federal government assumes 

greater financial responsibility for 

prescription drug expenditures 

with the introduction of Medicare 

part D, federal policymakers are 

increasingly concerned about 

prescription drug prices. GAO was 

asked to examine the change in 

retail prices and other pricing 

benchmarks for drugs frequently 

used by Medicare beneficiaries and 

other individuals with health 

insurance from 2000 through 2004. 

To examine the change in retail 

prices from 2000 through 2004, we 

obtained usual and customary 

(U&C) prices from two state 

pharmacy assistance programs for 

drugs frequently used by Medicare 

beneficiaries and non-Medicare 

enrollees in the 2003 Blue Cross 

and Blue Shield (BCBS) Federal 

Employee Program (FEP). The 

U&C price is the price an individual 

without prescription drug coverage 

would pay at a retail pharmacy. 

Additionally, we compared the 

change in U&C prices for brand 

drugs from 2000 through 2004 to 

the change in two pricing 

benchmarks: average 

manufacturer price (AMP), which 

is the average of prices paid to 

manufacturers by wholesalers for 

drugs distributed to the retail 

pharmacy class of trade, and 

average wholesale price (AWP), 

which represents the average of list 

prices that a manufacturer suggests 

wholesalers charge pharmacies. 
Page i GAO-05-779 Prescription Drug Price Trends 

Letter 1

Results in Brief 4 

Background 5 

Retail Prices Increased from 2000 through 2004, with Larger 

Increases for Brand Than Generic Drugs 6 

AWPs Increased at a Faster Rate Than AMPs and U&C Prices for 

50 Brand Drugs from 2000 through 2004 11 

Concluding Observations 13 

Agency and Other External Comments 14 

Appendix I Scope and Methodology 16 

Appendix II Drugs Included in Analyses 20 

Appendix III GAO Contact and Staff Acknowledgments 24 

Table 

Table 1: Ninety-Six Drugs Included in U&C Price Indexes, by 

Month, January 2000 through December 2004 20 

Figures 

Figure 1: Drug Prices for Different Buyers and Sellers 6 

Figure 2: Index of Average U&C Prices for 96 Drugs Frequently 

Used by BCBS FEP Enrollees, by Month, 2000 through 

2004 7 

Figure 3: Annual Change in U&C Price Index for 96 Drugs 

Frequently Used by BCBS FEP Enrollees, 2000 through 

2004 8 

Figure 4: Indexes of Average U&C Prices for Drugs Frequently 

Used by BCBS FEP Medicare and Non-Medicare 

Enrollees, by Month, 2000 through 2004 10 

Figure 5: Indexes of Average U&C Prices for 50 Brand and 46 

Generic Drugs Frequently Used by BCBS FEP Enrollees, 

by Month, 2000 through 2004 11 

Contents 
Page ii GAO-05-779 Prescription Drug Price Trends 

Figure 6: Indexes of AMPs, AWPs, and Average U&C Prices for 50 

Brand Drugs Frequently Used by BCBS FEP Enrollees, by 

Quarter, 2000 through 2004 12 

Figure 7: Comparison of 10 Drugs Accounting for the Largest 

Portions of Changes in AMP, AWP, and U&C Price 

Indexes for 50 Brand Drugs Frequently Used by BCBS 

FEP Enrollees, by Quarter, 2000 through 2004 13 

Abbreviations 

AMP average manufacturer price 

AWP average wholesale price 

BCBS Blue Cross and Blue Shield 

BLS Bureau of Labor Statistics 

CMS Centers for Medicare & Medicaid Services 

EPIC Elderly Pharmaceutical Insurance Coverage 

FEP Federal Employee Program 

NDC National Drug Code 

PACE Pharmaceutical Assistance Contract for the Elderly 

U&C usual and customary 

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Page 1 GAO-05-779 Prescription Drug Price Trends 

August 15, 2005 

The Honorable Olympia J. Snowe 

Chair 

Committee on Small Business and Entrepreneurship 

United States Senate 

The Honorable Ron Wyden 

United States Senate 

Prescription drug spending as a share of national health expenditures 

increased from 5.8 percent in 1993 to 10.7 percent in 2003 and was the 

fastest growing segment of health care expenditures.1

 In addition to 

increasing utilization and the introduction of newer drugs, rising 

prescription drug prices are a key component of increasing drug 

expenditures. Increasing drug prices can affect consumers, employers, and 

federal and state governments. Policymakers are increasingly concerned 

about drug prices as the federal government will assume greater financial 

responsibility for prescription drug expenditures with the introduction of a 

prescription drug benefit to Medicare beneficiaries in January 2006, 

known as Medicare part D. Medicare beneficiaries also will continue to be 

responsible for a large share of drug costs under Medicare part D. 

Tracking prescription drug prices can be complicated by the different 

prices that different purchasers, such as consumers, insurers and other 

third-party payers, and wholesalers, pay for the same drug. Several price 

benchmarks represent these differing amounts paid by different 

purchasers. For example, individuals without prescription drug coverage, 

including Medicare beneficiaries who do not currently have drug coverage, 

may pay the full retail price at the pharmacy, known as the usual and 

customary (U&C) price. Insurers and other third-party payers, including 

state Medicaid programs, typically pay negotiated prices with retail 

pharmacies, often receiving discounts from the average wholesale price 

(AWP), commonly referred to as a list price.2

 Retail pharmacies may obtain 

 1

Our calculations are based on data from the national health accounts prepared by the 

Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics 

Group. 

2

The AWP is the average of the list prices that a manufacturer suggests wholesalers charge 

pharmacies. 

United States Government Accountability Office

Washington, DC 20548 
Page 2 GAO-05-779 Prescription Drug Price Trends 

drugs directly from pharmaceutical manufacturers or through wholesalers. 

The average manufacturer price (AMP) represents the average of prices 

paid to manufacturers by wholesalers for drugs distributed to the retail 

pharmacy class of trade, and is used by the Centers for Medicare & 

Medicaid Services (CMS) to determine rebates due by law to Medicaid 

programs. Prices also substantially vary depending on whether drugs are 

marketed as brand or generic, with some third-party payers encouraging 

the use of less expensive generic drugs through lower cost sharing for 

consumers and other strategies. 

To provide a baseline of prescription drug prices before the 

implementation of the Medicare part D drug benefit, you asked GAO to 

review drug price changes from 2000 through 2004, including drugs 

frequently used by seniors. Specifically, we examined the following 

questions. 

1. How have retail prices for prescription drugs frequently used by 

Medicare beneficiaries and other individuals with health insurance 

changed from 2000 through 2004? 

2. How does the change in retail prices for brand drugs frequently used 

by Medicare beneficiaries and other individuals compare to other drug 

pricing benchmarks from 2000 through 2004? 

To examine the change in retail prices for prescription drugs frequently 

used by Medicare beneficiaries and other individuals with health 

insurance, we selected the 100 most frequently dispensed retail 

prescriptions in 2003 for Medicare beneficiaries and for non-Medicare 

enrollees in the Blue Cross and Blue Shield (BCBS) Federal Employee 

Program (FEP).3

 Combined, these two lists of 100 frequently used drugs 

represented a total of 133 unique drugs. Of these 133 drugs, we analyzed 96 

drugs (50 brand and 46 generic) for which we were able to obtain U&C 

prices at retail pharmacies for every month from January 2000 through 

 3

We used data of frequently dispensed prescriptions from BCBS FEP because they 

represent a large number of retail prescriptions dispensed and could provide data for drugs 

used by FEP enrollees who were Medicare beneficiaries and those who were not Medicare 

eligible. Of the nearly 55 million retail prescriptions dispensed to BCBS FEP enrollees in 

2003, 21 million were for FEP enrollees who were also Medicare beneficiaries. 
Page 3 GAO-05-779 Prescription Drug Price Trends 

December 2004.4 These 96 drugs included 75 drugs that were frequently 

used by BCBS FEP Medicare enrollees and 76 drugs that were frequently 

used by BCBS FEP non-Medicare enrollees, with 55 of these drugs 

overlapping the Medicare and non-Medicare frequently used lists. To 

calculate a price index, we weighted each drug using the number of 

prescriptions dispensed to BCBS FEP enrollees in 2003. We collected the 

average monthly U&C prices for a typical 30-day supply from two large 

state programs that assist low-income Medicare beneficiaries in 

purchasing prescription drugs: Pennsylvania’s Pharmaceutical Assistance 

Contract for the Elderly (PACE) program from January 2000 through 

December 2004, and New York’s Elderly Pharmaceutical Insurance 

Coverage (EPIC) program from August 2000 through December 2004.5

To compare the change in U&C prices at retail pharmacies with other 

drug-pricing benchmarks, we examined changes in the AMP and AWP for 

the 50 brand drugs frequently used by BCBS FEP enrollees. We calculated 

a quarterly AMP index for a 30-day supply for the 50 brand drugs based on 

data we collected from CMS from the first quarter of 2000 through the 

fourth quarter of 2004. We calculated a quarterly AWP index for a 30-day 

supply for the same 50 brand drugs based on data we collected from First 

DataBank for the same period. We determined that the data from BCBS 

FEP, PACE, EPIC, CMS, and First DataBank were sufficiently reliable for 

our purposes. Our analyses are limited to drugs most frequently used by 

Medicare beneficiaries and non-Medicare enrollees in the 2003 BCBS FEP, 

and our analyses using U&C prices are limited to prices reported by retail 

pharmacies in Pennsylvania to the PACE program and by retail 

pharmacies in New York to the EPIC program. See appendix I for more 

information about our selected drugs and detailed information on our 

 4

For the purpose of this report, we refer to single-source and multisource drugs that are 

marketed under a proprietary, trademark-protected name as brand drugs. Single-source 

drugs include those brand drugs that have no generic equivalent on the market and are 

generally available from only one manufacturer. Brand multisource drugs include those 

brand drugs that have generic equivalents available from multiple manufacturers and are 

marketed under their brand name. Generic drugs include multisource drugs that are 

chemically identical to their branded counterparts and are generally marketed by multiple 

manufacturers under a non-proprietary name. 

5

We used data from PACE and EPIC because they were two of the largest state 

pharmaceutical assistance programs, collected data from pharmacies on U&C prices for 

drugs, and had historical price data available from 2000. 
Page 4 GAO-05-779 Prescription Drug Price Trends 

methodology. We performed our work from April 2004 through July 2005 

in accordance with generally accepted government auditing standards.6

From January 2000 through December 2004, based on our analysis of data 

from PACE and EPIC, the average monthly U&C prices for a 30-day supply 

of 96 prescription drugs frequently used by BCBS FEP Medicare and nonMedicare enrollees increased 24.5 percent. Twenty of the 96 drugs 

accounted for nearly two-thirds of the increase in the U&C price index. 

The average U&C prices for 75 prescription drugs frequently used by 

BCBS FEP Medicare beneficiaries and the average U&C prices for 76 

prescription drugs frequently used by BCBP FEP non-Medicare enrollees 

increased at similar rates of 24.0 percent and 24.8 percent, respectively. 

The average U&C prices for 50 brand prescription drugs increased 

28.9 percent, three times as much as the average U&C price increase of 

9.4 percent for 46 generic prescription drugs. 

The AWP index increased by 31.6 percent for the 50 frequently used brand 

drugs from the first quarter of 2000 through the fourth quarter of 2004—

about 3 to 4 percentage points more rapidly than the AMP and U&C price 

indexes. Ten drugs in each index accounted for nearly 50 percent of the 

increase for the AMP, AWP, and U&C indexes, with 8 of these top 10 drugs 

consistent for all three prices. As a result of AWP’s faster rate of increase, 

AWP as a percentage of U&C price increased from an average of about 

91 percent in the first quarter of 2000 to about 94 percent in the last 

quarter of 2004. AMP stayed about 72 percent of the U&C price during this 

period. 

We provided a draft of this report to CMS, PACE, EPIC, and BCBS FEP. 

CMS noted that U&C and AWP do not reflect discounts in a drug’s price. 

While our analysis does not reflect these discounts, our focus was to 

examine price trends rather than price levels and U&C and AWP are 

consistent measures used to examine price trends. CMS also suggested 

that we examine the effect on prices when generic alternatives are 

introduced, but such an analysis was beyond the scope of this report. 

 6

We also reported on trends in U&C prices for 99 drugs from January 2000 through June 

2004 in GAO, Prescription Drugs: Trends in Usual and Customary Prices for Drugs 

Frequently Used by Medicare and Non-Medicare Enrollees, GAO-05-104R (Washington, 

D.C.: Oct. 6, 2004). This report includes 3 fewer drugs than our earlier analysis because 

pricing data were not available for these 3 drugs through December 2004. 

Results in Brief 
Page 5 GAO-05-779 Prescription Drug Price Trends 

PACE and BCBS provided technical comments that we incorporated as 

appropriate; EPIC stated that it did not have any comments. 

Several measures of price are commonly used within the health care 

sector to measure the price of prescription drugs. These varying price 

measures are due to the different prices that drug manufacturers and retail 

pharmacies charge different purchasers, and drug prices can vary 

substantially depending on the purchaser. (See fig. 1.) 

• The U&C price, the retail price for a drug, is the price an individual 

without prescription drug coverage would pay at a retail pharmacy. The 

U&C price includes the acquisition cost of the drug paid by the retail 

pharmacy and a markup charged by the pharmacy. 

• AWP is the average of the list prices or sticker price that a manufacturer of 

a drug suggests wholesalers charge pharmacies. AWP is typically less than 

the U&C price, which includes the pharmacy’s own markup. AWP is not 

the actual price that large purchasers normally pay. Nevertheless, AWP is 

part of the formula used by many state Medicaid programs and private 

third-party payers to reimburse retail pharmacies.7

• AMP is the average of prices paid to a manufacturer by wholesalers for a 

drug distributed to the retail pharmacy class of trade, after subtracting any 

account cash discounts or other price reductions.8

 CMS uses AMP in 

determining rebates drug manufacturers must provide, as required by the 

Omnibus Budget Reconciliation Act of 1990, to state Medicaid programs as 

a condition for the federal contribution to Medicaid spending for the 

manufacturers’ outpatient prescription drugs.9

 For brand drugs, the 

 7

Before 2005, Medicare reimbursement for prescription drugs covered under Medicare part 

B was based on AWP. The average sales price generally replaced AWP as the basis for 

outpatient drug reimbursement under Medicare part B beginning in 2005. The average sales 

price is defined for each drug as a manufacturer’s sales to all purchasers in a given quarter, 

net of discounts and rebates and excluding certain government and other purchasers, 

divided by the number of units of the drug sold by the manufacturer in that quarter. 

Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L. No. 108-

173, § 303(c), 117 Stat. 2066, 2239-2245 (to be codified at 42 U.S.C. § 1395w-3a). 

8

AMP does not include prices to government purchasers based on the Federal Supply 

Schedule, which are prices for prescription drugs negotiated with manufacturers by the 

Department of Veterans Affairs. AMP also does not include prices from direct sales to 

health maintenance organizations and hospitals or prices to wholesalers when they relabel 

drugs they purchase under their own label. 

9

Pub. L. No. 101-508, § 4401, 104 Stat. 1388, 1388-156 (codified as amended at 42 U.S.C. § 

1396r-8(k) (2000)). 

Background 
Page 6 GAO-05-779 Prescription Drug Price Trends 

minimum rebate amount is the number of units of the drug multiplied by 

15.1 percent of the AMP. 

Figure 1: Drug Prices for Different Buyers and Sellers 

a

U&C is the price an individual without prescription drug coverage would pay at a retail pharmacy. 

b

When an insured consumer purchases a drug at a retail pharmacy, the pharmacy collects from the 

insured consumer the appropriate cost-sharing amount and then submits a claim to the third-party 

payer for reimbursement. 

c

Third-party payers often negotiate a discount off AWP, the average of the list prices that a 

manufacturer suggests wholesalers charge pharmacies. However, third-party payers may pay other 

negotiated rates not based on AWP. 

d

Retail pharmacies can also purchase prescription drugs directly from manufacturers. 

e

AMP represents the average of prices paid to manufacturers by wholesalers for drugs distributed to 

the retail pharmacy class of trade. 

From January 2000 through December 2004, the average U&C prices for a 

typical 30-day supply of 96 prescription drugs frequently used by BCBS 

FEP Medicare and non-Medicare enrollees increased 24.5 percent. The 

average U&C prices for 75 prescription drugs frequently used by Medicare 

beneficiaries and for 76 prescription drugs frequently used by nonMedicare enrollees increased at similar rates. The average U&C prices for 

50 frequently used brand drugs increased three times faster than the 

average U&C prices for 46 frequently used generic drugs. 

Retail Prices 

Increased from 2000 

through 2004, with 

Larger Increases for 

Brand Than Generic 

Drugs 

Source: GAO. 

Retail pharmacy

Uninsured

consumer

Insured

consumer

Manufacturer

Wholesaler U&Ca

$

AMPe

$

Retail pharmacy

Retail pharmacyd

Third-party 

payerc

 Cost

shareb

 AWP

- discount $

Buyer Buyer Buyer

Seller Seller Seller
Page 7 GAO-05-779 Prescription Drug Price Trends 

From January 2000 through December 2004, the average U&C price 

collected from retail pharmacies by PACE and EPIC for a 30-day supply 

for 96 prescription drugs frequently used by BCBS FEP Medicare 

beneficiaries and non-Medicare enrollees increased 24.5 percent, a 

4.6 percent average annual rate of increase. (See fig. 2.) During the same 

period, using nationwide data from the Bureau of Labor Statistics (BLS), 

prices for prescription drugs and medical supplies for all urban consumers 

increased 21.3 percent, a 4.0 percent average annual rate of increase. 

Additionally, using BLS data, prices for all consumer items for all urban 

consumers—the Consumer Price Index—increased 12.7 percent, a 

2.5 percent average annual rate of increase from January 2000 through 

December 2004. 

Figure 2: Index of Average U&C Prices for 96 Drugs Frequently Used by BCBS FEP 

Enrollees, by Month, 2000 through 2004 

While U&C prices increased each year from 2000 through 2004, the 

greatest annual rate of increase—6.1 percent—occurred from January 

2002 to January 2003. (See fig. 3.) Since then, annual rates of increase have 

U&C Prices for Frequently 

Used Drugs Increased 

24.5 Percent 

124.5

100

105

0

110

115

120

125

130

1/2000 1/2001 1/2002 1/2003 1/2004

U&C

Index (Base = January 2000)

Source: GAO analysis of data from BCBS FEP, EPIC, and PACE.
Page 8 GAO-05-779 Prescription Drug Price Trends 

been less, increasing 5.2 percent from January 2003 to January 2004 and 

4.2 percent from January 2004 to December 2004.10

Figure 3: Annual Change in U&C Price Index for 96 Drugs Frequently Used by BCBS 

FEP Enrollees, 2000 through 2004 

Note: The change in average U&C prices from January 2004 through December 2004 is expressed 

as an annual percentage change. 

Twenty drugs, representing 33 percent of BCBS FEP prescriptions for the 

96 drugs we reviewed, accounted for 64 percent of the total increase in the 

U&C price index from January 2000 through December 2004.11 The drug 

with the largest effect on the price index was Lipitor 10mg, which 

accounted for 6.6 percent of the total increase. Nineteen of the 20 drugs 

were brand drugs and 1 was a generic drug, Hydrocodone/Acetaminophen 

5/500mg. The twenty drugs accounting for the largest changes in the U&C 

price index are listed below. 

 10The change in average U&C prices from January 2004 through December 2004 is 

expressed as an annual percentage change. 

11We measured the share each drug contributed to the overall index by comparing the ratio 

of (1) each drug’s price change from January 2000 through December 2004 multiplied by its 

weight based on BCBS FEP prescriptions, to (2) the sum of all drugs’ price changes 

multiplied by their associated weights. 

3.7

3.5

6.1

5.2

4.2

0

1

2

3

4

5

6

7

1/2000-

1/2001

1/2001-

1/2002

1/2002-

1/2003

1/2003-

1/2004

1/2004-

12/2004

Percentage change

Source: GAO analysis of data from BCBS FEP, EPIC, and PACE.
Page 9 GAO-05-779 Prescription Drug Price Trends 

• Lipitor 10mg 

• Celebrex 200mg 

• Plavix 75mg 

• Prevacid 30mg 

• Lipitor 20mg 

• Ambien 10mg 

• Zocor 20mg 

• Levaquin 500mg 

• Hydrocodone/Acetaminophen 5/500mg 

• Flonase 0.05mg 

• Zithromax 250mg 

• Wellbutrin SR 150mg 

• Singular 10mg 

• Premarin 0.625mg 

• Celexa 20mg 

• Zoloft 50mg 

• Evista 60mg 

• Norvasc 5mg 

• Neurontin 300mg 

• Aciphex 20mg 

From January 2000 through December 2004, the average U&C prices 

collected by PACE and EPIC for 75 prescription drugs frequently used by 

BCBS FEP Medicare beneficiaries increased at a similar rate as the 

average U&C prices for 76 prescription drugs frequently used by BCBS 

FEP non-Medicare enrollees.12 (See fig. 4.) The prices of 75 Medicare drugs 

increased 24.0 percent, a 4.5 percent average annual rate of increase. The 

prices of 76 non-Medicare drugs increased 24.8 percent, a 4.6 percent 

average annual rate of increase.13

 12While 55 drugs were used in calculating both the Medicare and non-Medicare U&C price 

indexes, each drug had a different weight in each index depending on the frequency of 

prescriptions dispensed to BCBS FEP Medicare enrollees or BCBS FEP non-Medicare 

enrollees. 

13We found the non-Medicare index rose slightly faster than the Medicare index, in part 

because drugs that treat depression were present to a larger extent in the non-Medicare 

index. The U&C prices for the eight drugs that treat depression increased at an average rate 

of 31.1 percent from January 2000 through December 2004. Excluding the eight drugs that 

treat depression from our analysis resulted in a 24.0 percent rate of increase for both the 

Medicare and non-Medicare index. 

U&C Prices for Drugs 

Frequently Used by 

Medicare Beneficiaries and 

by Non-Medicare Enrollees 

Increased at Similar Rates 
Page 10 GAO-05-779 Prescription Drug Price Trends 

Figure 4: Indexes of Average U&C Prices for Drugs Frequently Used by BCBS FEP 

Medicare and Non-Medicare Enrollees, by Month, 2000 through 2004 

From January 2000 through December 2004, the average U&C price (based 

on PACE and EPIC data) for 50 frequently used brand drugs rose three 

times faster than the average U&C price for 46 frequently used generic 

drugs. (See fig. 5.) Specifically, the average U&C price for brand drugs 

increased 28.9 percent, a 5.3 percent average annual rate of increase, 

whereas U&C prices for generic drugs increased 9.4 percent, a 1.8 percent 

average annual rate of increase. 

U&C Prices Increased 

Three Times Faster for 

Brand Drugs Than for 

Generic Drugs 

Source: GAO analysis of data from BCBS FEP, EPIC, and PACE.

124.0

124.8

100

105

0

110

115

120

125

1/2000 1/2001 1/2002 1/2003 1/2004

Medicare

Non-Medicare

Index (base = January 2000)
Page 11 GAO-05-779 Prescription Drug Price Trends 

Figure 5: Indexes of Average U&C Prices for 50 Brand and 46 Generic Drugs 

Frequently Used by BCBS FEP Enrollees, by Month, 2000 through 2004 

From the first quarter of 2000 through the fourth quarter of 2004, AMPs 

and U&C prices for the 50 brand drugs increased at similar rates, but 

AWPs increased at a faster rate. The quarterly AWPs for 50 brand 

prescription drugs increased 31.6 percent, a 6.0 percent average annual 

rate of increase. For these same 50 drugs, the quarterly AMPs increased 

28.2 percent, a 5.4 percent average annual rate of increase, while the 

average quarterly U&C prices increased 27.5 percent, a 5.2 percent average 

annual rate of increase.14 Over the entire period, the AWP index increased 

about 3 to 4 percentage points more than the AMP or U&C price indexes. 

(See fig. 6.) 

 14The quarterly U&C price index increased at a slightly lower rate of increase than the 

monthly U&C price index because the base and end periods differ. Whereas the base period 

for the monthly U&C index is January 2000, the base period for the quarterly index is 

January through March 2000. Similarly, the end period for the monthly index is December 

2004 and for the quarterly index is October through December 2004. 

AWPs Increased at a 

Faster Rate Than 

AMPs and U&C Prices 

for 50 Brand Drugs 

from 2000 through 

2004 

128.9

109.4

95

100

0

105

110

115

120

125

130

135

1/2000 1/2001 1/2002 1/2003 1/2004

Brand name

Generic

Index (base = January 2000)

Source: GAO analysis of data from BCBS FEP, EPIC, and PACE.
Page 12 GAO-05-779 Prescription Drug Price Trends 

Figure 6: Indexes of AMPs, AWPs, and Average U&C Prices for 50 Brand Drugs 

Frequently Used by BCBS FEP Enrollees, by Quarter, 2000 through 2004 

The difference between the levels of AWP and U&C prices for brand drugs 

narrowed slightly during the time period we analyzed. Whereas in the first 

quarter of 2000 AWP was on average about 91 percent of the U&C price for 

the same drug, by the fourth quarter of 2004 AWP was on average about 

94 percent of the U&C price. In contrast, AMP stayed a similar portion of 

U&C in first quarter 2000 and fourth quarter 2004, with the AMP on 

average about 72 percent of the U&C price. 

Ten brand drugs in each index, representing one-third or more of the 

prescriptions for the 50 brand drugs, accounted for almost 50 percent of 

the increase for the quarterly AMP, AWP, and U&C price indexes. Eight of 

these 10 drugs were the same across all three price indexes. The drug 

accounting for the largest portion of the change in the AMP and AWP 

indexes was Celebrex 200mg, accounting for 8.6 percent of the increase 

for AMP and 7.5 percent for AWP. Lipitor 10mg was the drug accounting 

for the largest portion of the change in the quarterly U&C price index and 

128.2

131.6

127.5

100

0

105

110

115

120

125

130

135

Q1/2000 Q1/2001 Q1/2002 Q1/2003 Q1/2004

AMP

AWP

U&C

Index (base = 1st Quarter 2000)

Source: GAO analysis of data from CMS, First DataBank, EPIC, PACE, and BCBS FEP.
Page 13 GAO-05-779 Prescription Drug Price Trends 

accounted for 7.2 percent of the increase for the 50 brand drugs. (See fig. 

7.) 

Figure 7: Comparison of 10 Drugs Accounting for the Largest Portions of Changes in AMP, AWP, and U&C Price Indexes for 

50 Brand Drugs Frequently Used by BCBS FEP Enrollees, by Quarter, 2000 through 2004 

From 2000 through 2004, retail prices for drugs frequently used by 

Medicare beneficiaries increased 24.0 percent—an average rate of 

4.5 percent per year. In general, higher drug prices mean higher spending 

by consumers and health insurance sponsors, including employers and 

federal and state governments. With brand drug prices increasing three 

times as fast as generic drug prices, public and private health insurance 

sponsors will likely continue to focus on strategies to encourage increased 

use of generic drugs when available. Starting in 2006, with the introduction 

of the Medicare prescription drug benefit, Medicare will be paying claims 

for a wider array of drugs and, as a result, the federal government will be 

affected more than previously by rising drug prices. 

We found that from 2000 through 2004, on average the AWPs for 50 

frequently used brand drugs rose 0.8 percent per year faster than the retail 

prices for these same drugs. A continuation of this difference between 

AWP and retail prices increases could affect many Medicaid programs and 

private third-party payers that base their reimbursement of drug claims on 

AWPs. 

Concluding 

Observations 

AMP

Celebrex 200mg

Plavix 75mg

Lipitor 10mg

Ambien 10mg

Lipitor 20mg

Prevacid 30mg

Levaquin 500mg

Zocor 20mg

Zithromax 250mg

Singulair 10mg

AWP

Celebrex 200mg

Plavix 75mg

Lipitor 10mg

Ambien 10mg

Prevacid 30mg

Lipitor 20mg

Levaquin 500mg

Zocor 20mg

Wellbutrin Sr 150mg

Flonase 0.05mg

U&C

Lipitor 10mg

Celebrex 200mg

Plavix 75mg

Prevacid 30mg

Lipitor 20mg

Ambien 10mg

Levaquin 500mg

Zocor 20mg

Zithromax 250mg

Flonase 0.05mg

Source: GAO analysis of data from CMS, First DataBank, EPIC, PACE, and BCBS FEP.

Percentage of 50 brand drug prescriptions: 36%

Percentage of price index’s increase: 49%

Percentage of 50 brand drug prescriptions: 33%

Percentage of price index’s increase: 48%

Percentage of 50 brand drug prescriptions: 37%

Percentage of price index’s increase: 46%
Page 14 GAO-05-779 Prescription Drug Price Trends 

We provided a draft of this report to CMS, PACE, EPIC, and BCBS FEP. In 

commenting on this report, CMS highlighted the discounts and price 

information tools that will be available under the Medicare drug benefit. 

CMS also stated that neither the U&C price nor AWP reflect discounts, 

such as manufacturers’ discount programs, or other price concessions 

affecting a drug’s price. We noted in the report that U&C represents the 

retail pharmacy price paid by consumers without insurance. The U&C 

does not reflect prices available from other sources, such as mail order 

pharmacies. We also noted that AWP is a list price that is not the actual 

price paid by large purchasers. We agree that consumers may be able to 

obtain lower prices than reflected by the U&C and AWP. However, the 

focus of our analysis was to examine price trends rather than price levels, 

and U&C and AWP are consistent measures used to assess price trends. 

Further, increases in the published AWP may increase what many public 

or private third-party purchasers pay for prescription drugs because AWP 

is often included in the formula to calculate payments to pharmacies. 

Additionally, CMS suggested that we examine the effect on prices when 

generic alternatives are introduced. We agree that the introduction of 

generic drugs can reduce consumer payments for drugs. Examining 

changes in consumer spending for drugs, which are also affected by 

changes in utilization and the introduction of new drug alternatives, would 

be useful, but was beyond the scope of this report in examining price 

trends for frequently-used brand and generic drugs. 

PACE and BCBS provided technical comments that we incorporated as 

appropriate; EPIC stated that it did not have any comments. 

As agreed with your offices, unless you publicly announce the contents 

earlier, we plan no further distribution of this report until 30 days after its 

date. We will then send copies of this report to the Administrator of CMS 

and other interested parties. We will also provide copies to others upon 

request. In addition, the report will be available at no charge on the GAO 

Web site at http://www.gao.gov. 

Agency and Other 

External Comments 
Page 15 GAO-05-779 Prescription Drug Price Trends 

If you or your staffs have any questions about this report, please call me at 

(202) 512-7114 or kanofm@gao.gov. Contact points for our Offices of 

Congressional Relations and Public Affairs may be found on the last page 

of this report. GAO staff who made major contributions to this report are 

listed in appendix III. 

Marjorie Kanof 

Managing Director, Health Care 
Appendix I: Scope and Methodology 

Page 16 GAO-05-779 Prescription Drug Price Trends 

To examine the change in retail prices for prescription drugs frequently 

used by Medicare beneficiaries and other individuals with health 

insurance, we used data from the Blue Cross and Blue Shield (BCBS) 

Federal Employee Program (FEP) to select the 100 prescription drugs 

most frequently dispensed through retail pharmacies in 2003 for BCBS 

FEP Medicare enrollees and the 100 most frequently dispensed for BCBS 

FEP non-Medicare enrollees.1

 Combined, these two lists included 133 

unique drugs.2

We obtained average monthly usual and customary (U&C) prices reported 

by retail pharmacies to Pennsylvania’s Pharmaceutical Assistance 

Contract for the Elderly (PACE) program from January 2000 through 

December 2004 and New York’s Elderly Pharmaceutical Insurance 

Coverage (EPIC) program from August 2000 through December 2004.3,4

 We 

collected prices based on a specific strength, dosage form, and common 

number of units (such as pills), typically for a 30-day supply.5

 Based on 

combined PACE and EPIC data, 96 of the 133 drugs we selected had prices 

reported for every month from January 2000 through December 2004. We 

 1

BCBS FEP covered nearly 55 million prescriptions dispensed to enrolled federal 

employees, retirees, and their dependents at retail pharmacies in 2003, including 21 million 

prescriptions for FEP enrollees who were also Medicare beneficiaries. The 96 drugs that 

we included in our analyses represented about 32 percent of total prescriptions dispensed 

to BCBS FEP enrollees in 2003. Of these 96 drugs, 50 were brand drugs and represented 

about 17 percent of total prescriptions dispensed to BCBS FEP enrollees in 2003. 

2

Drugs with the same name but with different forms (such as capsules or tablets) or 

number of units dispensed were counted separately as unique drugs. 

3

PACE covered more than 9 million prescriptions and EPIC covered nearly 10 million 

prescriptions dispensed to mostly low-income seniors in 2003. As of June 2005, PACE 

officials reported that approximately 2,800 retail pharmacies—95 percent of pharmacies in 

Pennsylvania—participated in PACE, while EPIC officials reported approximately 4,150 

retail pharmacies—87 percent of pharmacies in New York—participated in EPIC. 

4

We merged price data from PACE and EPIC for August 2000 through December 2004, but 

report price data from PACE alone for January 2000 through July 2000. Because the 

average of the U&C prices reported by PACE and by EPIC were nearly identical, we do not 

believe that including the EPIC data beginning in August 2000 notably affected the price 

trend. 

5

The Department of Veterans Affairs Pharmacy Benefits Management Strategic Healthcare 

Group provided the most common number of units for a retail prescription for a 30-day 

supply. 

Appendix I: Scope and Methodology 
Appendix I: Scope and Methodology 

Page 17 GAO-05-779 Prescription Drug Price Trends 

analyzed price trends on a monthly basis from January 2000 through 

December 2004 for these 96 drugs.6

Of the 96 drugs, 75 were among those most frequently used by BCBS FEP 

Medicare enrollees, and 76 were among those most frequently used by 

BCBS FEP non-Medicare enrollees. Fifty-five of the 96 drugs were 

frequently used by both BCBS Medicare enrollees and non-Medicare 

enrollees.7

 We first determined the total number of prescriptions in 2003 

for the drugs we selected dispensed to BCBS FEP Medicare enrollees and 

the total number of prescriptions dispensed to BCBS FEP non-Medicare 

enrollees. Separately for drugs frequently used by Medicare and by nonMedicare enrollees, we calculated the share of the total number of BCBS 

FEP prescriptions attributed to each drug. The price of each drug was then 

weighted by its relative share of total Medicare or total non-Medicare 

prescriptions in 2003 to calculate the average price for frequently used 

Medicare drugs and the average price for frequently used non-Medicare 

drugs for each month from January 2000 through December 2004.8,9

 We 

standardized these averages to create a Medicare price index and a nonMedicare price index, each with a value of 100 as of January 2000. 

We also separately analyzed monthly trends in U&C prices for brand and 

generic drugs frequently used by BCBS FEP enrollees. Of the 96 drugs, 50 

were brand drugs and 46 were generic drugs. Similar to our calculation of 

 6

We also analyzed price trends for 117 drugs that had prices reported for every month from 

January 2002 through December 2004, which had an average annual rate of increase of 

5.2 percent. For the 96 drugs that had reported prices for every month from January 2000 

through December 2004, the average annual rate of increase from January 2002 through 

December 2004 was also 5.2 percent. 

7

While these 55 drugs were used in calculating both the Medicare and non-Medicare U&C 

price indexes, they had different weights in each index depending on the frequency of 

prescriptions dispensed to BCBS FEP enrollees who were either Medicare beneficiaries or 

not Medicare eligible. 

8

BCBS FEP retail prescriptions represent various days supply (such as 34- or 90-day 

supply), while PACE and EPIC price data we obtained are limited only to retail 

prescriptions for a typical 30-day supply. Over half of BCBS FEP retail prescriptions are for 

a 30-day supply. 

9

The 2003 BCBS FEP retail prescription drug weights applied to PACE and EPIC retail 

prices for 96 drugs from January 2000 through December 2004 were held constant 

throughout the entire period of the analysis. We also obtained 2004 BCBS FEP retail 

prescription data for 89 of the 96 drugs and found almost no difference in the change in the 

U&C price index for the 89 drugs using constant 2003 or 2004 BCBS FEP drug weights 

throughout the period of analysis. 
Appendix I: Scope and Methodology 

Page 18 GAO-05-779 Prescription Drug Price Trends 

Medicare and non-Medicare price indexes, we calculated indexes for 

brand drugs and generic drugs based on each drug’s share of the total 

number of brand or generic prescriptions dispensed to BCBS FEP 

enrollees in 2003. 

To examine the change in retail prices for frequently used drugs compared 

to other drug price benchmarks, we compared an index based on the U&C 

prices reported by PACE and EPIC for 50 brand drugs to indexes based on 

the average manufacturer prices (AMP) and average wholesale prices 

(AWP) for these 50 drugs on a quarterly basis from the first quarter of 2000 

through the fourth quarter of 2004.10 The Centers for Medicare & Medicaid 

Services (CMS) requires manufacturers to report AMP within 30 days of 

the end of each calendar quarter. Manufacturers submit AWPs on a 

periodic basis to publishers of drug-pricing data, such as First DataBank. 

Using the National Drug Codes (NDC)11 reported by PACE and EPIC for 

the U&C prices for the 50 brand drugs, we obtained per unit AMPs from 

CMS and per unit AWPs from First DataBank associated with each NDC.12

For each drug, we calculated a quarterly AMP and a quarterly AWP by 

multiplying the per unit price by the most common number of units for a 

30-day supply.13 We created an AMP and AWP index by weighting the 50 

brand drugs by the number of prescriptions in 2003 from BCBS FEP. 

 10These 50 brand drugs were frequently used by Medicare beneficiaries and non-Medicare 

enrollees in the BCBS FEP in 2003 and had reported U&C prices to PACE and EPIC for 

every month from January 2000 through December 2004. 

11NDCs are three segment numbers that are the universal product identifiers for drugs for 

human use; the U.S. Food and Drug Administration assigns the first segment of the NDC, 

which identifies the firm that manufacturers, repackages, or distributes a drug. The second 

segment identifies a specific strength, dosage form, and formulation for a particular firm 

and the third segment identifies package size. A single drug can have multiple NDCs 

associated with it. For example, a drug made by one manufacturer, in one form or strength, 

but in three package sizes would have three NDCs. 

12We obtained quarterly AMPs from CMS for each two-segment NDC, represented by 9 

digits (not accounting for package size), associated with the 50 brand drugs from the first 

quarter of 2000 through the fourth quarter of 2004. Similarly, we obtained monthly AWPs 

from First DataBank for each three-segment NDC, represented by 11 digits, associated with 

the 50 brand drugs from first quarter 2000 through fourth quarter 2004. Specifically, we 

obtained the AWP effective on the last day of each month for each 11-digit NDC. 

13For brand drugs with multiple 9-digit NDCs, we calculated an average quarterly AMP for 

the drug weighted by the number of PACE and EPIC prescriptions for each 9-digit NDC 

during that quarter. For brand drugs with multiple 11-digit NDCs, we calculated an average 

monthly AWP for the drug weighted by the number of PACE and EPIC prescriptions during 

that month. We created a quarterly AWP by taking a simple average of the three monthly 

prices in each quarter. 
Appendix I: Scope and Methodology 

Page 19 GAO-05-779 Prescription Drug Price Trends 

Similarly, we recalculated the U&C price for the 50 brand drugs on a 

quarterly basis to make comparisons to AMP and AWP. 

We also determined how much each drug’s change in price contributed to 

the overall change in price for the 50 brand drugs for AMPs, AWPs, and 

U&C prices. We measured the share each drug contributed to the overall 

index by comparing the ratio of (1) each drug’s price change from January 

2000 through December 2004 multiplied by its weight based on BCBS FEP 

prescriptions, to (2) the sum of all drugs price changes multiplied by their 

associated weights. 

Our analyses are limited to drugs most frequently used by Medicare 

beneficiaries and by non-Medicare enrollees in the 2003 BCBS FEP. 

Additionally, our analyses using U&C prices are limited to prices reported 

by retail pharmacies in Pennsylvania to the PACE program and by retail 

pharmacies in New York to the EPIC program. We reviewed the reliability 

of data from BCBS FEP, CMS, First DataBank, EPIC, and PACE, including 

screening for outlier prices in the PACE and EPIC data and ensuring that 

the price trends and frequently used drugs were consistent with other data 

sources. We determined that these data were sufficiently reliable for our 

purposes. We performed our work from April 2004 through July 2005 in 

accordance with generally accepted government auditing standards. 
Appendix II: Drugs Included in Analyses 

Page 20 GAO-05-779 Prescription Drug Price Trends 

Table 1 lists the 96 drugs used in constructing monthly U&C price indexes 

from January 2000 through December 2004. Fifty of the 96 drugs are brand 

drugs and were also used in examining price changes in AMP, AWP, and 

U&C on a quarterly basis from first quarter 2000 through fourth quarter 

2004. Of the 96 drugs, 75 were frequently used by Medicare beneficiaries 

and 76 were frequently used by non-Medicare enrollees, with 55 of these 

drugs frequently used by both Medicare beneficiaries and non-Medicare 

enrollees. 

Table 1: Ninety-Six Drugs Included in U&C Price Indexes, by Month, January 2000 through December 2004 

Drug name and strength 

Units dispensed and 

dosage form for a typical 

30-day supply 

Brand or 

generic 

Medicare or nonMedicare 

Acetaminophen/Codeine 30/300mg 60 tablets Generic Both 

Aciphex 20mg 30 tablets 

delayed release 

Brand Both 

Albuterol 90mcg 17gm aerosol Generic Both 

Allegra-D 60-120 mg 60 tablets 

extended release 

Brand Non-Medicare 

Allopurinol 300mg 30 tablets Generic Medicare 

Alprazolam 0.25mg 60 tablets Generic Both 

Alprazolam 0.5mg 60 tablets Generic Both 

Ambien 5mg 30 tablets Brand Medicare 

Ambien 10mg 30 tablets Brand Both 

Amoxicillin 500mg 21 capsules Generic Both 

Aricept 10mg 30 tablets Brand Medicare 

Atenolol 25mg 30 tablets Generic Both 

Atenolol 50mg 30 tablets Generic Both 

Carisoprodol 350mg 90 tablets Generic Non-Medicare 

Celebrex 200mg 60 capsules Brand Both 

Celexa 20mg 30 tablets Brand Both 

Cephalexin 500mg 30 capsules Generic Both 

Cipro 500mg 20 tablets Brand Non-Medicare 

Clonazepam 0.5mg 60 tablets Generic Non-Medicare 

Combivent 103-18mcg 14.7gm aerosol Brand Medicare 

Cosopt 2-0.5% 5mL solution Brand Medicare 

Coumadin 5mg 30 tablets Brand Medicare 

Cozaar 5mg 30 tablets Brand Medicare 

Cyclobenzaprine HCl 10mg 60 tablets Generic Non-Medicare 

Appendix II: Drugs Included in Analyses 
Appendix II: Drugs Included in Analyses 

Page 21 GAO-05-779 Prescription Drug Price Trends 

Drug name and strength 

Units dispensed and 

dosage form for a typical 

30-day supply 

Brand or 

generic 

Medicare or nonMedicare 

Doxycycline Hyclate 100mg 30 capsules Generic Non-Medicare 

Effexor XR 75mg 30 capsules 

extended release 

Brand Non-Medicare 

Effexor XR 150mg 30 capsules 

extended release 

Brand Non-Medicare 

Evista 60mg 30 tablets Brand Both 

Flomax 0.4mg 30 capsules Brand Both 

Flonase 0.05mg 16gm spray Brand Both 

Folic Acid 1mg 30 tablets Generic Both 

Furosemide 20mg 60 tablets Generic Both 

Furosemide 40mg 60 tablets Generic Both 

Hydrochlorothiazide 25mg 30 tablets Generic Both 

Hydrocodone/Acetaminophen 5/500mg 90 tablets Generic Both 

Hydrocodone/Acetaminophen 7.5/500mg 90 tablets Generic Both 

Hydrocodone/Acetaminophen 7.5/750mg 90 tablets Generic Non-Medicare 

Ibuprofen 800mg 90 tablets Generic Non-Medicare 

Isosorbide Mononitrate 30mg 30 tablets 

extended release 

Generic Medicare 

Isosorbide Mononitrate 60mg 30 tablets 

extended release 

Generic Medicare 

Klor-Con 10 10mEq 30 tablets 

extended release 

Generic Medicare 

Lanoxin 125mcg 30 tablets Brand Medicare 

Lanoxin 250mcg 30 tablets Brand Medicare 

Levaquin 500mg 10 tablets Brand Both 

Lipitor 10mg 30 tablets Brand Both 

Lipitor 20mg 30 tablets Brand Both 

Lipitor 40mg 30 tablets Brand Non-Medicare 

Lorazepam 0.5mg 60 tablets Generic Both 

Lorazepam 1mg 60 tablets Generic Both 

Meclizine HCl 125mg 90 tablets Generic Medicare 

Methylprednisolone 4mg 30 tablets Generic Non-Medicare 

Metoprolol Tartrate 50mg 60 tablets Generic Both 

Miralax 17gm 255gm powder Brand Medicare 

Naproxen 500mg 60 tablets Generic Non-Medicare 

Nasacort AQ 55mcg 16.5gm spray Brand Non-Medicare 

Nasonex 50mcg 17gm spray Brand Non-Medicare 
Appendix II: Drugs Included in Analyses 

Page 22 GAO-05-779 Prescription Drug Price Trends 

Drug name and strength 

Units dispensed and 

dosage form for a typical 

30-day supply 

Brand or 

generic 

Medicare or nonMedicare 

Neurontin 300mg 90 capsules Brand Both 

Norvasc 5mg 30 tablets Brand Both 

Norvasc 10mg 30 tablets Brand Both 

Oxycodone/Acetaminophen 5/325mg 90 tablets Generic Non-Medicare 

Paxil 20mg 30 tablets Brand Both 

Penicillin V Potassium 500mg 30 tablets Generic Non-Medicare 

Plavix 75mg 30 tablets Brand Both 

Potassium Chloride 10mEq 60 capsules 

extended release 

Generic Medicare 

Potassium Chloride 10mEq 30 tablets 

extended release 

Generic Medicare 

Pravachol 20mg 30 tablets Brand Medicare 

Pravachol 40mg 30 tablets Brand Both 

Prednisone 5mg 30 tablets Generic Medicare 

Prednisone 10mg 35 tablets Generic Both 

Prednisone 20mg 30 tablets Generic Non-Medicare 

Premarin 0.625mg 30 tablets Brand Both 

Prevacid 30mg 30 capsules 

delayed release 

Brand Both 

Promethazine HCl 25mg 60 tablets Generic Non-Medicare 

Propoxyphene Napsylate/Acetaminophen 100/650mg 90 tablets Generic Both 

Ranitidine HCl 150mg 60 tablets Generic Both 

Singulair 10mg 30 tablets Brand Both 

Spironolactone 25mg 30 tablets Generic Medicare 

Sulfamethoxazole/Trimethoprim 800/160mg 20 tablets Generic Both 

Synthroid 50mcg 30 tablets Brand Both 

Synthroid 75mcg 30 tablets Brand Both 

Synthroid 100mcg 30 tablets Brand Both 

Toprol XL 50mg 30 tablets 

extended release 

Brand Both 

Toprol XL 100mg 30 tablets 

extended release 

Brand Both 

Trazodone HCl 50mg 90 tablets Generic Both 

Triamterene/Hydrochlorothiazide 37.5/25mg 30 capsules Generic Both 

Triamterene/Hydrochlorothiazide 37.5/25mg 30 tablets Generic Both 

Warfarin Sodium 5mg 30 tablets Generic Medicare 

Wellbutrin SR 150mg 60 tablets 

extended release 

Brand Non-Medicare 
Appendix II: Drugs Included in Analyses 

Page 23 GAO-05-779 Prescription Drug Price Trends 

Drug name and strength 

Units dispensed and 

dosage form for a typical 

30-day supply 

Brand or 

generic 

Medicare or nonMedicare 

Xalatan 0.005% 2.5mL solution Brand Both 

Zithromax 200mg/5mL 30 suspension Brand Non-Medicare 

Zithromax 250mg 6 tablets Brand Both 

Zocor 20mg 30 tablets Brand Both 

Zocor 40mg 30 tablets Brand Both 

Zoloft 50mg 30 tablets Brand Both 

Zoloft 100mg 30 tablets Brand Both 

Zyrtec 10mg 30 tablets Brand Both 

Source: GAO analysis of data from BCBS FEP, EPIC, and PACE. 
Appendix III: GAO Contact and Staff 

Acknowledgments 

Page 24 GAO-05-779 Prescription Drug Price Trends 

Marjorie Kanof (202) 512-7114 or kanofm@gao.gov 

In addition to the contact named above, John E. Dicken, Director; Rashmi 

Agarwal; Jessica L. Cobert; Martha Kelly, Matthew L. Puglisi; and Daniel S. 

Ries made key contributions to this report. 

Appendix III: GAO Contact and Staff 

Acknowledgments 

GAO Contact 

Acknowledgments 

(290356) 
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