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This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2021, with a focus on stand-alone drug plans. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the national Part D drug plans available in 2021.
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 use of mail-order pharmacies has been rising in recent years as patients have often been incentivized or mandated to use mail service for convenience and…
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…
9 of 10 Most Commonly Used ARVs in Part D Had List Prices Above Inflation Download
All 10 Part D ARVs w Highest Spending Had Price Increases Above Inflation Download
Three-quarters of Part D ARVs Had Price Increases Above Inflation Download
Most ARVs Covered by Medicare Part D are Brand Single Source Download
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.
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