Supplementary Online Content Song H, Adamson A, Mostaghimi A. Medicare Part D payments for topical steroids: rising costs and potential savings. JAMA Dermatol. Published online April 28, 2017. doi:10.1001/jamadermatol.2017.1130 eTable 1. Topical Steroids with Steroid Classes (All Available Strengths of Medication) and Steroid Groups eTable 2. Total Medicare Spending and Potential Savings and Total Out-of-pocket Costs and Potential Out-of-pocket Savings for Patients, Adjusted for Inflation and Reported in 2015 Dollars eTable 3. Changes in Utilization and Spending on Individual Brand and Generic Topical steroids, Arranged by Decreasing Claim Count This supplementary material has been provided by the authors to give readers additional information about their work. © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eTable 1. Topical Steroids with Steroid Classes (All Available Strengths of Medication) and Steroid Groups Brand Name Generic Name Steroid Classes Steroid Group Clobetasol Propionate Clobetasol Propionate I I Betamethasone Dipropionate Betamethasone/Propylene Glyc I I Diprolene Betamethasone Diproprionate I I Halobetasol Propionate Halobetasol Propionate I I Vanos Fluocinonide I I Temovate Clobetasol Propionate I I Ultravate Halobetasol Propionate I I Fluocinonide Fluocinonide I-III II Betamethasone Dipropionate Betamethasone Dipropionate I-III, V II Desoximetasone Desoximetasone II-III II Halog Halcinonide II II Topicort Desoximetasone II-III II Triamcinolone Acetonide Triamcinolone Acetonide III-VI III-IV Betamethasone Valerate Betamethasone Valerate III, V, VI III-IV Celestone Betamethasone Valerate III, V, VI III-IV Hydrocortisone Valerate Hydrocortisone Valerate IV, V III-IV Kenalog Triamcinolone Acetonide III-VI III-IV Clocortolone Pivalate Clocortolone Pivalate IV III-IV Cloderm Clocortolone Pivalate IV III-IV Westcort Hydrocortisone Valerate IV-V V-VI Hydrocortisone Hydrocortisone IV, V, VII V-VI Desonide Desonide V-VI V-VI Hydrocortisone Butyrate Hydrocortisone Butyrate V V-VI Locoid Hydrocortisone Butyrate V V-VI Desowen Desonide V-VI V-VI Synalar Fluocinolone Acetonide IV-VI V-VI Beta-Val Betamethasone Valerate V-VI V-VI Lokara Desonide VI V-VI Dexamethasone Dexamethasone VII VII Cortisone Acetate Cortisone Acetate VII VII Cortisone Cortisone Acetate VII VII Scalacort Hydrocortisone VII VII © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eTable 2. Total Medicare Spending and Potential Savings and Total Out-of-pocket Costs and Potential Out-of-pocket Savings for Patients, Adjusted for Inflation and Reported in 2015 Dollars Year 2011 2012 2013 2014 2015 Cumulative Inflation 5.40% 3.20% 1.70% 0.10% Reported in 2015 dollars Medicare spending Class I $60,053,785.01 $79,291,677.80 $103,147,079.54 $203,277,644.86 $423,013,599.98 Class II $67,421,682.99 $90,765,853.53 $107,365,932.07 $128,587,123.21 $143,605,111.25 Class III-IV $68,691,973.89 $90,544,199.88 $110,380,795.49 $119,435,429.78 $110,740,946.48 Class V-VI $33,313,451.59 $46,628,707.51 $90,512,330.86 $111,730,270.34 $88,571,769.62 Class VII $8,168,961.42 $8,213,593.26 $8,630,557.25 $9,030,277.58 $10,003,039.10 Total $237,649,854.90 $315,444,031.97 $420,036,695.21 $572,060,745.78 $775,934,466.43 Patient out-of-pocket spending Class I $10,506,414.28 $13,307,892.56 $16,303,976.37 $22,199,405.38 $37,680,690.12 Class II $9,534,508.82 $11,013,914.81 $13,472,106.98 $15,807,323.50 $20,840,714.71 Class III-IV $13,350,741.79 $16,893,045.00 $21,080,593.27 $23,618,274.89 $26,113,295.79 Class V-VI $5,766,485.22 $6,743,831.30 $10,480,588.81 $12,386,366.18 $14,600,018.53 Class VII $2,250,150.31 $2,333,827.57 $2,509,286.44 $2,259,671.87 $2,597,067.69 Total $41,408,300.43 $50,292,511.23 $63,846,551.87 $76,271,041.83 $101,831,786.84 Potential Medicare savings Class I $13,047,251.58 $10,270,442.97 $19,874,012.88 $71,012,400.15 $295,628,729.00 Class II $38,801,681.23 $35,288,329.59 $36,474,357.00 $20,539,301.70 $41,643,569.07 Class III-IV $4,221,897.74 $7,633,614.37 $14,851,665.75 $27,205,298.96 $28,500,998.40 Class V-VI $25,614,767.96 $38,222,443.45 $80,204,303.85 $77,112,822.83 $56,444,941.28 Class VII $394,464.34 $602,775.96 $276,517.24 $407,999.15 $552,080.30 © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 Total $82,080,062.83 $92,017,606.35 $151,680,856.72 $196,277,822.78 $422,770,318.05 Potential out-of-pocket savings for patients Class I $842,980.19 $1,089,107.55 $1,557,101.68 $3,056,228.56 $14,597,525.28 Class II $3,342,973.39 $2,949,055.37 $3,449,943.08 $2,995,823.38 $1,771,475.94 Class III-IV $1,408,124.17 $1,426,259.62 $1,400,163.34 $2,227,737.81 $2,888,136.02 Class V-VI $2,381,023.54 $3,335,706.04 $6,542,972.97 $2,775,338.53 $6,217,349.66 Class VII $83,434.00 $90,839.40 $57,787.93 $46,868.25 $62,758.61 Total $8,058,535.29 $8,890,967.97 $13,007,969.01 $11,101,996.53 $25,537,245.50 © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eTable 3. Changes in Utilization and Spending on Individual Brand and Generic Topical steroids, Arranged by Decreasing Claim Count Name Brand/ Potency Total spending (2011- % change claim count % change % change average user spending Generic group 15) (2011-15) unit count (2011- (2011-15) 15) Triamcinolone Acetonide III-IV 53.82% -11.29% Generic $368,409,427.94 42.54% Clobetasol Propionate I $714,819,719.57 59.58% 57.25% 605.25% Generic Fluocinonide Generic II $235,734,559.62 3.09% 1.81% 396.25% Hydrocortisone V-VI $95,036,184.57 Generic 51.32% 49.02% 0.26% Dexamethasone VII $41,570,965.21 Generic 41.99% 15.24% -8.18% Desonide V-VI $260,404,370.18 Generic -8.49% -22.68% 330.05% Betamethasone II $132,211,780.87 35.23% Dipropionate Generic 27.23% 35.01% Desoximetasone II $157,365,347.50 Generic -20.68% -20.94% 14.18% Betamethasone/ I $76,021,731.44 Propylene Glyc Generic 13.73% 13.87% -3.56% Betamethasone Valerate III-IV $45,876,388.91 Generic 35.49% 31.40% 105.22% Hydrocortisone Valerate III-IV $66,877,666.08 Generic -5.75% -8.89% 354.41% Halobetasol Propionate I $61,025,871.51 Generic 9.80% 9.77% 192.88% Hydrocortisone Butyrate V-VI $10,835,888.80 -12.01% -75.53% 207.46% Generic Cortisone Acetate VII $2,469,755.51 Generic -79.89% -77.31% 364.92% Beta-val Brand V-VI $163,519.50 N/A N/A N/A Kenalog Brand III-IV $10,056,127.03 -62.25% -53.50% 119.99% Vanos I $15,914,241.15 -97.55% Brand -97.61% 483.36% Cloderm III-IV $6,078,882.83 -80.19% -74.63% 154.05% Brand Hanalog II $8,359,365.63 Brand -18.64% 1.65% 276.55% Celestone Brand III-IV $193,144.71 N/A N/A N/A © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 Locoid Brand V-VI $3,891,971.35 -30.69% -15.73% 156.50% Topicort II $4,074,649.44 Brand 317.63% 572.56% 121.52% Ultravate I $310,066.54 -84.07% -85.22% 77.54% Brand Diprolene I $353,055.13 -27.33% -23.54% 90.45% Brand Temovate I $339,101.85 -27.86% -26.59% 100.80% Brand Cortisone VII $2,287.62 Brand N/A N/A N/A Desowen V-VI $195,151.58 Brand 820.00% 604.92% -52.39% Lokara V-VI $6,104.53 Brand N/A N/A N/A Westcort V-VI $7,935.59 N/A N/A N/A Brand Scalacort VII $3,420.26 N/A Brand N/A N/A Clocortolone Pivalate III-IV $2,301,708.03 N/A N/A Generic N/A Synalar V-VI $215,403.83 N/A N/A Brand N/A N/A=Not available because no value in either 2011 or 2015 © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021.