The Fixed Basket
The Fixed Basket · Stratum rx_drugs

Healthcare — prescription drugs

12 generic prescription molecules at NADAC acquisition cost. The fixed good is the therapeutic molecule (an FDA-bioequivalent generic is the same good, not a substitute); 2000's drugs deflate as generics matured. NADAC 2013+, chain-link entry.

Weight (National Average)
1.56%
Sources
12
precedence-ordered ladder
Archetypes published
10
Basket version
v1.0.14

Sources

Precedence ladder for healthcare — prescription drugs. Lower precedence wins where multiple sources cover the same period. The engine walks the ladder per period with chain-link rescale at source transitions.

PrecedenceSourceSeries IDCadenceGeography
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_metformin_hcl_500mg_tablet weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_atorvastatin_20mg_tablet weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_lisinopril_10mg_tablet weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_levothyroxine_50mcg_tablet weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_amoxicillin_500mg_capsule weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_omeprazole_dr_20mg_capsule weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_simvastatin_20mg_tablet weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_sertraline_50mg_tablet weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_lansoprazole_dr_30mg_capsule weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_paroxetine_20mg_tablet weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_fluoxetine_20mg_capsule weekly (rolled to monthly) national
0 NADAC (CMS National Average Drug Acquisition Cost) nadac_clopidogrel_75mg_tablet weekly (rolled to monthly) national

Weight across archetypes

How healthcare — prescription drugs is weighted in each of the 10 published archetypes. Sorted by weight, highest first. National Average is the headline citation surface.

ArchetypeWeightAction
Retiree 3.4549% View archetype →
Income — Second Quintile 1.8669% View archetype →
Income — Lowest Quintile 1.8278% View archetype →
Homeowner 1.7850% View archetype →
National Average 1.5572% View archetype →
Income — Middle Quintile 1.5450% View archetype →
Income — Fourth Quintile 1.5397% View archetype →
Income — Highest Quintile 1.4479% View archetype →
Working Parent 1.1600% View archetype →
Renter 1.0083% View archetype →

Substitution history

Substitution log entries that touched this stratum. Each entry bumps the basket version and is reproducible from observations tagged with their basket_version.

2026-06-29 — Healthcare out-of-pocket split into rx_drugs + medical_services

Version: methodology 2.0.5 → 2.1.0

What changed. The single healthcare_oop stratum (5 generic drugs + 2 physician CPT codes) was split into rx_drugs (12 generic prescription molecules at NADAC acquisition cost) and medical_services (physician CMS PFS + hospital outpatient CMS OPPS + dental and vision from MEPS survey-weighted out-of-pocket). The prior weight was divided by the CEX-2000 out-of-pocket shares — drugs 38.4%, medical services 61.6% — preserving each archetype's total exactly. Strata count 15 → 16.

Why. The old stratum was both too narrow and conceptually wrong. The fixed good for a drug is the therapeutic MOLECULE: an FDA-bioequivalent generic is the same good, not a cheaper substitute, so tracking molecules at prevailing generic prices is correct — and it means 2000's drugs honestly DEFLATE (−3.7%/yr) as generics matured. (An earlier brand-only basket was built and rejected: it measured the price a brand-loyalist would pay for a label, which no household experiences.) The real defect was breadth — dental, vision, broad physician and hospital care were all missing, and those inflate (+3.0%/yr).

Effect on headline. National Average headline 3.56 → 3.59%/yr; Retiree 3.31 → 3.39%/yr. Two limits are disclosed rather than engineered away: CMS PFS/OPPS are administered Medicare prices, so medical_services is a floor relative to private prices; and a fixed-2000 basket structurally cannot contain drugs that did not exist in 2000 (biologics, GLP-1s), so rx_drugs shows 2000's drugs getting cheaper while real pharmacy spending rose. That gap is the fixed-basket premise's limit, carried by the chained companion.

Methodology

See the basket page for all 17 strata and the per-stratum source map. The methodology page covers the load-bearing pillars including the rules around source-precedence ladders, chain-link splicing at source transitions, and the no-fabricated-data invariant.