Who Paid My Doc
Spiriva Handihaler
Tiotropium Bromide
Open in the dashboardPart D claims
320,158
Drug cost
$224,551,839
Prescribers
16,732
In 2024, Medicare Part D recorded 320,158 claims for Spiriva Handihaler (tiotropium bromide) from 16,732 prescribers, at a total drug cost of $224.6 million paid at the pharmacy by Medicare, patients and others.
Where it is prescribed
By the prescriber's state · 54 states and territories| State | Relative to the most | Prescribers | Claims | Drug cost |
|---|---|---|---|---|
| WI | 817 | 18,641 | $13,382,845 | |
| OH | 942 | 18,456 | $13,133,966 | |
| NC | 828 | 15,768 | $10,706,228 | |
| WA | 696 | 14,909 | $11,564,426 | |
| CA | 863 | 14,828 | $9,548,475 | |
| FL | 665 | 13,722 | $9,685,106 | |
| NY | 696 | 13,135 | $9,230,819 | |
| TN | 603 | 12,598 | $8,736,540 | |
| MO | 613 | 12,522 | $8,516,885 | |
| MI | 662 | 11,890 | $8,393,037 | |
| PA | 645 | 11,003 | $7,113,900 | |
| IL | 597 | 10,889 | $7,945,438 | |
| TX | 574 | 10,584 | $7,510,386 | |
| VA | 533 | 10,283 | $7,383,072 | |
| CO | 453 | 8,822 | $6,667,089 |
The other 39 states and territories
| State | Prescribers | Claims | Drug cost |
|---|---|---|---|
| IN | 451 | 8,402 | $6,323,311 |
| MN | 422 | 7,663 | $5,265,146 |
| KY | 368 | 7,195 | $4,847,618 |
| IA | 349 | 7,090 | $4,853,852 |
| MA | 348 | 6,170 | $4,134,954 |
| GA | 342 | 6,145 | $4,251,095 |
| AZ | 290 | 5,989 | $4,551,880 |
| OR | 313 | 5,870 | $4,140,721 |
| LA | 285 | 5,574 | $3,759,606 |
| WV | 248 | 5,425 | $4,238,649 |
| NJ | 281 | 5,247 | $3,572,712 |
| CT | 235 | 5,017 | $3,799,808 |
| OK | 222 | 4,043 | $2,621,286 |
| AR | 195 | 3,802 | $2,429,297 |
| AL | 199 | 3,227 | $2,093,614 |
| ME | 150 | 3,016 | $2,373,828 |
| SC | 186 | 3,008 | $2,129,473 |
| ID | 150 | 2,679 | $1,834,690 |
| MT | 138 | 2,452 | $1,760,628 |
| NE | 150 | 2,418 | $1,514,570 |
| KS | 143 | 2,333 | $1,449,453 |
| PR | 96 | 2,045 | $1,108,029 |
| MS | 108 | 1,927 | $1,291,708 |
| VT | 102 | 1,696 | $1,268,146 |
| RI | 89 | 1,638 | $1,009,261 |
| MD | 106 | 1,622 | $1,103,458 |
| NM | 89 | 1,613 | $1,133,193 |
| NH | 89 | 1,507 | $1,163,388 |
| DE | 51 | 1,361 | $1,079,422 |
| ND | 63 | 1,189 | $751,584 |
| UT | 75 | 1,096 | $694,698 |
| NV | 61 | 1,047 | $728,501 |
| SD | 48 | 817 | $489,848 |
| WY | 35 | 636 | $436,055 |
| DC | 34 | 617 | $443,996 |
| HI | 15 | 221 | $153,692 |
| AK | 12 | 199 | $171,140 |
| GU | 5 | 89 | $46,902 |
| VI | 2 | 23 | $14,416 |
The state is where the prescriber practices, not where the patient lives. Totals are Medicare Part D claims only.
Which specialties prescribe it
Top 15 of 52| Specialty | Relative to the most | Prescribers | Claims | Drug cost |
|---|---|---|---|---|
| Family Practice | 5,220 | 87,993 | $60,960,811 | |
| Pulmonary Disease | 2,645 | 71,495 | $54,544,558 | |
| Internal Medicine | 3,653 | 65,012 | $43,899,991 | |
| Nurse Practitioner | 3,075 | 56,158 | $38,169,867 | |
| Physician Assistant | 1,024 | 18,526 | $13,010,562 | |
| Critical Care (Intensivists) | 287 | 7,093 | $5,277,376 | |
| Geriatric Medicine | 136 | 2,526 | $1,521,206 | |
| General Practice | 155 | 2,483 | $1,487,062 | |
| Allergy/ Immunology | 86 | 1,539 | $1,071,924 | |
| Hospitalist | 78 | 1,286 | $810,403 | |
| Emergency Medicine | 58 | 1,089 | $680,403 | |
| Student in an Organized Health Care Education/Training Program | 68 | 949 | $572,152 | |
| Cardiology | 34 | 482 | $340,730 | |
| Sleep Medicine | 20 | 475 | $396,545 | |
| Infectious Disease | 30 | 446 | $242,956 |
Specialty is the one printed on each prescriber's Medicare claims.
Largest prescribers
First 5 of 100 by claims · 2024Two separate records. Claims come from Medicare and related payments from Open Payments. They are shown in one row because they name the same product; they do not show that a payment affected a prescription.
| Prescriber | Specialty | State | Claims | Drug cost | Related payments |
|---|---|---|---|---|---|
| Jorge Sanchez-Masiques | Pulmonary Disease | FL | 1,302 | $675,592 | None on record |
| Raed Hamed | Internal Medicine | WI | 310 | $183,681 | None on record |
| Omesh Toolsie | Pulmonary Disease | WI | 298 | $166,212 | None on record |
| Irina Zolotarevskaya | Pulmonary Disease | NY | 232 | $117,894 | None on record |
| Farah Sagheer | Pulmonary Disease | FL | 226 | $117,726 | None on record |
"No profile" means the prescriber has no Open Payments record here; "None on record" means no payment naming this product in the payment year. Related payments are general payments, and one that names several products is split evenly, so an amount is payments related to the product, not money paid for it. The list is the prescribers with the most claims, up to 100 per drug.
See more in the dashboard: 25 with a free account, all 100 with PatronIndustry payments naming this drug
From CMS Open PaymentsOpen Payments names products as manufacturers reported them, and CMS does not link them to Part D drugs, so this match is by name and ours. The two records are separate: they do not show that a payment affected a prescription.
Other names for tiotropium bromide
What this means
Medicare Part D is the part of Medicare that covers prescription drugs dispensed at a pharmacy. Each year CMS publishes, for every prescriber and drug, how many claims were dispensed and what they cost. This page adds those up for one drug.
A claim is one prescription filled, refills included. Drug cost is the total paid at the pharmacy by Medicare, the patient and anyone else; it is not money to the prescriber. CMS leaves out any prescriber with fewer than 11 claims of a drug, so the prescriber count is a floor and a missing prescriber does not mean none.
Part D covers drugs dispensed to Medicare beneficiaries at a pharmacy. It does not include drugs given in a clinic or hospital, patients with other insurance, or the most recent year, which Medicare publishes about two years behind.