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Memorandum: Projected Spending for Prescription Drugs by and on Behalf of Medicare Enrollees 1 (February 2003)

handle is hein.congrec/cbo9263 and id is 1 raw text is: February 3, 2003

To:          Interested Parties
From:        Tom Bradley
Subject:     Projected spending for prescription drugs by and on behalf of Medicare enrollees.
The Congressional Budget Office (CBO) has recently updated its projection of aggregate spending
for outpatient prescription drugs by and on behalf of Medicare beneficiaries. As shown in the
attached table, CBO estimates that spending for outpatient prescription drugs for Medicare
beneficiaries will total $1.84 trillion over the 2004-2013 period.
That estimate, which takes into account recent information and reflects other steps we have taken
to improve our projection, represents an increase of about 4 percent over our projection last year that
spending on prescription drugs for Medicare beneficiaries would total $1.77 trillion over the 2003-
2012 period.
Starting the 10-year projection period one-year later is the main reason for that increase, since it adds
a relatively expensive year (2013) to the projections while dropping a relatively inexpensive year
(2003). Indeed, that shift in the projection period would by itself increase our projection by about
11 percent. That increase was reduced, however, for two reasons, both of which take into account
new information we have received about drug spending:
*    First, we now estimate that actual spending for prescription drugs for Medicare
beneficiaries was about 2.3 percent lower in 2000 than we had estimated in last year's
projection. That revision is based largely on new information about the degree to which
drug spending is under-reported in surveys, which led us to use a slightly smaller
adjustment for under-reporting in our estimates.
*    Second, compared to last year, we have decreased slightly our projections of the rate of
growth in drug spending, due in part to slower-than-expected economic growth in the near
term.
The combination of a lower starting point and slower growth results in projected spending on
prescription drugs for Medicare beneficiaries that is lower in each year than we projected a year ago.
That reduction, which averages 7 percent over the 2003-2012 period, grows from 5 percent in 2003
to 8 percent in 2012. (The 4 percent increase in CBO's projection of spending during the 2004-2013
period, compared to last year's projection for the 2003-2012 period, is the result of combining the
average reduction of 7 percent in projected spending for each year with the 11 percent increase from
starting the projection period one year later.)
It is important to note the estimated cost of a specific Medicare drug benefit proposal from last year
(but with effective dates delayed by one year) could change by more or less than the change in the
baseline, depending on the details of the proposal.

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