Prescription Drug Profiles PUF

This release contains the Prescription Drug Profiles Public Use Files (PUFs) drawn from Medicare prescription drug claims for the year of the date on which the prescription was filled. The PUFs includes beneficiary demographics (e.g., gender, age), plan characteristics (e.g., plan type, drug benefit type, gap coverage), prescription drug characteristics (i.e., active ingredient, drug class), prescriber characteristics, and payment information (e.g., average patient pay amount).  

The CMS Prescription Drug Profiles PUFs are aggregated files in which each record is a profile or cell defined by the characteristics of Medicare beneficiaries, drugs, plans, and prescribers.

The Prescription Drug Profiles PUFs represents 100% of prescription drug claims (subject to suppression) for Medicare beneficiaries covered by Part D for the reference year.  These files provide various measures of utilization as averages for different groups of Medicare beneficiaries, or profiles. Prescription drug events (or Part D Drug Event Files) are merged with the following files to construct the Prescription Drug Profiles PUF for the reference year:

• Beneficiary Summary File;
• Part D Plan Characteristics File;
• Part D Prescriber Characteristics File;
• RxNorm, available from the U.S National Library of Medicine, National Institutes of Health;
• National Formulary, available from the Department of Veterans Affairs; and
• Results of the CMS-RxHCC risk-adjustment model.

Then, the information is aggregated into profiles defined by 14 variables: (1) Gender; (2) Age category; (3) Drug name; (4) Drug RxNorm Concept Unique Identifier RxCUI; (5) Drug class; (6) Drug major class;  (7) Drug type, (8) Plan type, (9) Coverage type; (10) Benefit phase; (11) Drug benefit type; (12) Prescriber taxonomy; (13) Plan gap coverage indicator; and (14) Tier identifier.  Finally, number of events and average utilization measures for each combination of profile variables are calculated.

In addition to the General documentation file, there are two documentation files for each Prescription Drug Profiles PUF:

1. The data dictionary and codebook file contains information about each variable on the file and its values.
2. A data users document which gives the file layout for the downloadable CSV file, as well as SAS program code for creating a SAS dataset with variable formats.