Variation in Drug Prescribing Across the U.S.

Most of the publicity about geographic variation in provision of medical services in the U.S. concerns surgical procedures or overall medical spending. Now, in a pair of articles, researchers have addressed variation in drug prescribing across 306 geographic regions for a random sample of 5% of Medicare beneficiaries who had Part D drug coverage in 2007.

Mean annual drug spending was 60% greater in the highest drug-spending region than in the lowest (US$2973 vs. $1854). Drug spending correlated only weakly with overall medical spending. The researchers also looked at two indicators of prescribing quality. First, they found a fourfold difference in prescribing of drugs considered to be high risk for older people (generally antihistamines, ant…