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Analysis Finds 14 Million Medicare Part D and Large Employer Plan Enrollees Used Mail-Order Pharmacies Pre-Pandemic, Top Drugs Filled Were to Treat Chronic Conditions
With questions being raised about potential delays in U.S. Postal Service delivery, a new KFF data note estimates 14 million enrollees in Medicare Part D and large employer plans relied on mail-order pharmacies for at least one prescription in 2018, with a total of over 170 million prescriptions fulfilled. The…
Mail Delays Could Affect Mail-Order Prescriptions for Millions of Medicare Part D and Large Employer Plan Enrollees
Potential changes in mail service delivery could be a concern for people who receive prescription drugs from mail-order pharmacies. To understand who may be most affected by delays in the delivery of prescription drugs, we analyzed use of mail order in Medicare Part D and large group employer plans, and identified the therapeutic classes and specific drugs with the highest volume of fills by mail-order pharmacies in each market.
In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.
Medicare Part D plan sponsors, which provide drug coverage to 45 million older adults and people with disabilities, have the option to relax their ‘refill too soon’ restrictions in response to the COVID-19 pandemic, as part of efforts to ensure adequate access to medications in disasters or emergencies. This analysis examines the share of Part D enrollees who currently have access to extended supplies of generic, brand-name, and specialty-tier drugs covered by their plan in 2020, prior to relaxation of any early-fill restrictions in response to the COVID-19 outbreak.
Drug price concerns in the U.S., including for antiretrovirals, the mainstay of HIV treatment and, increasingly prevention, have prompted the introduction of several policy proposals. One proposal would require manufacturers to provide a rebate to the federal government if prices increase faster than inflation. We assessed list price changes for ARVs under Part D, which is required to cover all or substantially all ARVs.
A Small Share of People with Medicare Advantage or Stand-alone Medicare Part D Coverage Voluntarily Switch Plans During Open Enrollment
A new KFF analysis finds that a relatively small share of people with Medicare Advantage or stand-alone Medicare Part D prescription drug coverage voluntarily switch plans during Medicare’s open enrollment period, which runs annually from Oct. 15 to Dec. 7. With less than a week remaining for beneficiaries to make…
This analysis finds that a relatively small share of people with Medicare Advantage or stand-alone Medicare Part D prescription drug coverage voluntarily switch plans during Medicare’s open enrollment period, which runs annually from Oct. 15 to Dec. 7. Shopping around among plans is important, since plans can vary significantly and change from year to year, which can have a large impact on enrollees’ coverage and costs.
In response to higher drug spending growth and heightened attention to drug prices, policymakers have proposed a variety of policy initiatives to lower the cost of prescription drugs in Medicare. This brief examines in detail the range of proposals offered by the Trump Administration and members of Congress for lowering the cost of prescription drugs, their known effects on the federal budget, and their potential implications for beneficiaries and other stakeholders.
Millions of Medicare Part D Enrollees Face Increases in Premiums and Other Costs in 2020 if They Do Not Switch Plans During Open Enrollment
Millions of current enrollees in stand-alone Medicare Part D prescription drug plans will face premium and other cost increases next year unless they switch to lower-cost plans during the open enrollment period that began Oct. 15 and ends on Dec. 7, a new KFF analysis finds. This includes two-thirds of…