Data for drugs available through low-cost prescription drug programs are available through pharmacy benefit manager and claims data

We used data from the Indiana Network for Patient Care to estimate the proportion of patients with type 2 diabetes to whom an oral hypoglycemic agent was dispensed. Based on these estimates, we compared the proportions of patients who received medications from chains that do and do not offer an LCPP, the proportion trend over time based on claims data from a single payer, and to proportions estimated from the Medical Expenditure Panel Survey (MEPS).We found that the proportion of patients with type 2 diabetes who received oral hypoglycemic medications did not vary based on whether the chain that dispensed the drug offered an LCPP or over time. Additionally, the rates were comparable to those estimated from MEPS.Researchers can be reassured that data for medications available through LCPPs continue to be available through administrative data sources.When pharmacies dispense a medication for a patient who has a drug benefit, they typically submit an electronic transaction to a pharmacy benefit management (PBM) adjudication system as a method to confirm eligibility and to request payment. The PBM returns a transaction which contains status data about the adjudication and later transfers the transaction data to the payer who contracted with them for services.In 2006, pharmacies introduced low-cost prescription programs (LCPP) offering selected generic medications that included those for common diseases, such as diabetes, hypertension, and asthma, for $5 or less for a 30-day supply (they sometimes offer a 90-day supply for $10 to $15) [1]. Researchers and others who rely on claims data became concerned that, since the dispensing pharmacy would be unlikely to receive additional reimbursement from the payer and there may be direct and indirect costs associated with submitting the claim, the pharmacy might often not submit a claim when the patient purchased one of these low cost prescriptions using cash. [2,3] Failing to submit claims for these drugs, many of which are comm