In 2022, 38 health benefit plan (HBPs) issuers reported the 25 most frequently prescribed drugs and some aspects of their prescription drug spending. The Texas Department of Insurance (TDI) collected the data under Texas Insurance Code 1369.503. TDI reports only what the HBPs supplied and doesn’t audit it. Percentages have been rounded to the nearest whole number.
25 Most frequently prescribed drugs
The table shows the number of issuers and the percent of issuers that reported each drug. For example, 55% of issuers, or 21 of the 38, prescribed Montelukast. Of 112 drugs reported, at least five issuers prescribed these drugs.
| Drug name | Drug class | Conditions treated | Total issuers | Percent of total issuers |
|---|---|---|---|---|
| Montelukast | leukotriene receptor antagonist | allergies; asthma | 21 | 55% |
| Metformin | biguanides | type 2 diabetes | 19 | 50% |
| Amphetamine and Dextroamphetamine | central nervous system stimulants | ADHD; narcolepsy | 19 | 50% |
| Albuterol | bronchodilator | asthma; COPD | 18 | 47% |
| Amoxicillin | antibiotic | bacterial infections | 17 | 45% |
| Pantoprazole | proton pump inhibitor | gastroesophageal reflux | 17 | 45% |
| Gabapentin | anticonvulsant | epilepsy; shingles pain | 17 | 45% |
| Hydrochlorothiazide | diuretic | high blood pressure; fluid retention | 17 | 45% |
| Azithromycin | antibiotic | bacterial infections | 16 | 42% |
| Prednisone | corticosteroid | inflammation | 15 | 39% |
| Rosuvastatin | statins | high cholesterol | 15 | 39% |
| COVID-19 vaccine | viral vaccine | immunity to SARS-CoV-2 | 14 | 37% |
| Omeprazole | proton pump inhibitor | gastroesophageal reflux | 14 | 37% |
| Fluticasone | corticosteroid | asthma; COPD | 14 | 37% |
| Escitalopram | SSRI | depression; anxiety | 14 | 37% |
| Sertraline | SSRI | anxiety; depression; OCD | 14 | 37% |
| Meloxicam | NSAID | arthritis | 14 | 37% |
| Losartan | angiotensin II receptor blocker | high blood pressure | 13 | 34% |
| Metoprolol | beta-blockers | high blood pressure; chest pain | 13 | 34% |
| Levothyroxine | thyroid hormone | hypothyroidism | 13 | 34% |
| Amoxicillin and Clavulanate Potassium | antibiotic; beta-lactamase inhibitor | bacterial infections | 12 | 32% |
| Vitamin D | vitamin | bone disorders | 12 | 32% |
| Amlodipine | calcium channel blocker | high blood pressure; chest pain | 12 | 32% |
| Bupropion | antidepressant | depression | 12 | 32% |
| Trazodone | serotonin modulators | depression | 11 | 29% |
| Ibuprofen | NSAID | mild to moderate pain | 11 | 29% |
Percent change in annual net spending on prescription drugs
- Seven issuers reported decreases in annual net spending:
○ -100%○ -12%○ -9%○ -1%○ <-1%○ -17%○ -11%- -100%
- -17%
- -12%
- -11%
- -9%
- -1%
- <-1%
- Eight issuers reported no changes.
- Twenty-three issuers reported increases in annual net spending:
○ 4%○ 9%○ 17%○ 35%○ 164%○ 5%○ 13%○ 19%○ 36%○ 720%○ 6%○ 14%○ 21%○ 38%○ 4,207%*○ 6%○ 15%○ 32%○ 58%○ 7%○ 16%○ 32%○ 70%
- 4%
- 5%
- 6%
- 6%
- 7%
- 9%
- 13%
- 14%
- 15%
- 16%
- 17%
- 19%
- 21%
- 32%
- 32%
- 35%
- 36%
- 38%
- 58%
- 70%
- 164%
- 720%
- 4,207%*
* The 4,207% increase reflects an HBP with an erroneous report for 2021, leading to this increase.
Percent change in premiums due to prescription drugs
- Four issuers reported decreases in premiums:
○ -913%○ -27%○ -12%○ -2%- -913%
- -27%
- -12%
- -2%
- Ten issuers reported no changes.
- Twenty-four issuers reported increases in premiums:
○ 1%○ 2%○ 3%○ 8%○ 33%○ 1%○ 2%○ 3%○ 9%○ 35%○ 1%○ 3%○ 3%○ 19%○ 74%○ 1%○ 3%○ 4%○ 22%○ 570%○ 2%○ 3%○ 7%○ 28%- 1%
- 1%
- 1%
- 1%
- 2%
- 2%
- 2%
- 3%
- 3%
- 3%
- 3%
- 3%
- 3%
- 4%
- 7%
- 8%
- 9%
- 19%
- 22%
- 28%
- 33%
- 35%
- 74%
- 570%
Percent of specialty drugs subject to use management requirements
- Five issuers reported no changes.
- Thirty-three issuers reported increases in drugs subject to use management requirements:
○ 1%○ 53%○ 78%○ 85%○ 100%○ 19%○ 63%○ 83%○ 85%○ 100%○ 24%○ 68%○ 83%○ 89%○ 100%○ 24%○ 68%○ 83%○ 89%○ 100%○ 27%○ 68%○ 83%○ 97%○ 100%○ 47%○ 70%○ 83%○ 100%○ 53%○ 77%○ 84%○ 100%- 1%
- 19%
- 24%
- 24%
- 27%
- 47%
- 53%
- 53%
- 63%
- 68%
- 68%
- 68%
- 70%
- 77%
- 78%
- 83%
- 83%
- 83%
- 83%
- 83%
- 84%
- 85%
- 85%
- 89%
- 89%
- 97%
- 100%
- 100%
- 100%
- 100%
- 100%
- 100%
- 100%
Premium reductions due to use management
The issuers reported savings of $341 million due to specialty drug use management.