Medicare Part D Drug Spending Delta & Top Movers API (CMS)

Track year-over-year Medicare Part D drug spending changes straight from the official, keyless CMS API — and instantly surface the top movers: the drugs whose Medicare spending, claims, beneficiary counts, and per-claim cost rose or fell the most between the two most recent years.

Most CMS Part D scrapers hand you a flat dump of raw spending columns. This Actor does the analytics for you: it computes the spend delta % per drug, the per-claim and per-beneficiary cost change, the beneficiary-count change, and ranks the whole formulary by movement — so you go from data to insight in one run.

Data source: the official CMS "Medicare Part D Spending by Drug" annual dataset on data.cms.gov (public, no API key, no login). The current edition covers 2019–2024 with ~14.5k drug/manufacturer rows. The Actor discovers the latest CMS distribution automatically, so it keeps working across annual releases.

Who it's for

• Pharma pricing & market access — see exactly where Medicare Part D dollars are moving and which competitors are gaining or losing spend and volume.
• PBMs & payers — spot the drugs driving Part D cost growth (per-claim and per-beneficiary) for formulary and rebate strategy.
• Health-policy analysts & researchers — quantify year-over-year drug cost trends with CMS's own change and CAGR figures included.
• Health journalists & watchdogs — find the fastest-rising drugs by spend or utilization, ready to cite.
• Investors / equity research — use Medicare claims, beneficiaries, and spend as a proxy for a drug's US market trajectory.

Example input

{
  "mode": "top_movers",
  "minSpendLatest": 100000000,
  "sortBy": "spending_change_pct",
  "sortDirection": "desc",
  "topN": 100,
  "requireLatestYear": true
}

Returns the 100 drugs (with at least $100M in latest-year Medicare Part D spending) whose total spending grew the most year over year.

Search a single drug or manufacturer instead:

{ "mode": "search", "drugName": "Ozempic" }

{ "mode": "search", "manufacturer": "Novo Nordisk", "sortBy": "total_spending_latest" }

Output fields (one record per drug, or per manufacturer)

Field	Description
brand_name, generic_name	Drug brand and generic name
manufacturer_name, manufacturer_count	Manufacturer (or Overall); number of manufacturers
latest_year, prior_year, first_year, years_covered	Data-year context for the delta
total_spending_latest / _prior	Total Medicare Part D spending (USD)
spending_change_pct, spending_change_abs	Year-over-year total-spending change (% and $)
total_claims_latest / _prior, claims_change_pct	Claims (fills) and their YoY change
total_beneficiaries_latest / _prior, beneficiaries_change_pct	Beneficiaries and their YoY change
avg_spend_per_claim_latest / _prior / _change_pct	Average spend per claim and its YoY change
avg_spend_per_beneficiary_latest / _prior / _change_pct	Average spend per beneficiary and its YoY change
avg_spend_per_dosage_unit_latest / _prior / _change_pct	Weighted average spend per dosage unit and its YoY change
total_dosage_units_latest	Total dosage units dispensed (latest year)
cms_chg_avg_spend_per_dosage_unit, cms_chg_year_pair	CMS-supplied per-unit change and its year pair
cms_cagr_avg_spend_per_dosage_unit, cms_cagr_year_range	CMS-supplied per-unit CAGR and its year range
outlier_flag_latest	CMS high-cost outlier flag (latest year)
spending_trend	rising / falling / flat
source_system, source_url	Provenance

Use as an MCP tool

This Actor is a clean, chainable tool for AI agents (Claude, Cursor, ChatGPT, etc.) via mcp.apify.com. Field-level output descriptions let an agent ask questions like "which Part D drugs had the biggest spending increase last year?" or "how did per-claim cost for Ozempic change?" and get structured, ready-to-reason answers.

FAQ

Do I need a CMS account or API key? No. The Actor uses the public CMS data API, which requires no authentication.

What years does it cover? The current CMS annual edition covers 2019–2024. Each drug's delta compares its two most recent reported years. The Actor auto-detects the newest edition on every run.

What does "top movers" mean? Drugs ranked by the size of their year-over-year change — by default the biggest total-spending increases. Switch sortBy / sortDirection to rank by per-claim cost change, beneficiary change, or absolute dollars, and set sortDirection: "asc" to find the biggest declines.

Why is a drug missing from top movers? By default requireLatestYear keeps only drugs reporting in the newest year (so every comparison is the same fresh period). Set it to false to include drugs that stopped reporting earlier.

One row per drug or per manufacturer? By default you get one Overall row per drug. Set includeManufacturerBreakdown: true (or filter by manufacturer) to also get per-manufacturer rows.

Is the data commercial-use OK? CMS publishes this as public U.S. Government data. Attribution to CMS is appreciated; verify your specific use against your industry's rules.

Pricing

Pay-per-result: you are billed per drug record written to the dataset. Empty result sets cost effectively nothing beyond the tiny Actor start.