Medicare Part D - Research and Data from KFF

Poll: 1 in 8 Adults Say They’ve Taken a GLP-1 Drug, Including 4 in 10 of Those with Diabetes and 1 in 4 of Those with Heart Disease

May 10, 2024

News Release

About one in eight adults (12%) say they have taken one of an increasingly popular class of prescription drugs known as GLP-1s that are used for weight loss and to treat diabetes and reduce the risk of heart disease and stroke, a new KFF Health Tracking Poll finds. This includes 6% of adults who say they are currently taking one of these drugs, which include Ozempic, Wegovy and MounjaroThe shares of adults who report ever…

An Estimated 1 in 4 Medicare Beneficiaries With Obesity or Overweight Could Be Eligible for Medicare Coverage of Wegovy, an Anti-Obesity Drug, to Reduce Heart Risk

Apr 24, 2024

News Release

In a new analysis, KFF finds that 3.6 million people with Medicare could be eligible for coverage of Wegovy (semaglutide) now that the Food and Drug Administration has approved the use of the anti-obesity drug to reduce the risk of heart attacks and stroke in certain patients. This change potentially allows access to Wegovy for just over 1 in 4 of the 13.7 million people on Medicare diagnosed with obesity or overweight, based on data…

A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity

Apr 24, 2024

Issue Brief

The FDA recently approved a new use for Wegovy, the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese - a decision that opens the door to Medicare coverage of Wegovy, which is prohibited by law from covering drugs used for obesity. This brief analyses how many Medicare beneficiaries could be eligible for the new use of Wegovy and the potential impact…

Gross Medicare Spending on Ozempic and Other GLP-1s Is Already Skyrocketing – Even Though Medicare Cannot Cover The Drugs for Weight Loss

Mar 23, 2024

News Release

A KFF analysis shows that gross total Medicare spending on Ozempic and other similar drugs has increased dramatically in recent years – even though Medicare is explicitly prohibited by law from covering the drugs for obesity. That’s because Medicare now covers the drugs, known as GLP-1s, for other medically accepted indications, including to treat diabetes. This week the Centers for Medicare & Medicaid Services (CMS) informed Medicare drug plans that they can cover Wegovy, another…

Medicare Spending on Ozempic and Other GLP-1s Is Skyrocketing

Mar 22, 2024

Policy Watch

This policy watch analyzes the latest data on Medicare Part D spending on GLP-1 drugs, initially approved to treat diabetes but in high demand as treatments for obesity, and shows how spending on these drugs has increased substantially in recent years.

Number of Low-Income Subsidy (LIS) Enrollees

Feb 9, 2024

State Health Facts Indicator

New $2,000 Medicare Part D Cap Could Reduce Out-of-Pocket Drug Costs for Over One Million Beneficiaries Beginning Next Year, Including Tens of Thousands of Beneficiaries in Most States

Feb 8, 2024

News Release

A KFF analysis shows that a new out-of-pocket spending cap in Medicare Part D could translate into savings for well over 1 million beneficiaries when it takes effect next year, including more than 100,000 people each in California, Florida and Texas, based on analyses of drug spending in 2021. The $2,000 cap, part of the Inflation Reduction Act of 2022, will lead to thousands of dollars in savings for Medicare patients who take high-cost drugs…

Millions of People with Medicare Will Benefit from the New Out-of-Pocket Drug Spending Cap Over Time

Feb 8, 2024

Issue Brief

In 2025, Medicare beneficiaries will pay no more than $2,000 out of pocket for prescription drugs covered under Part D, Medicare’s outpatient drug benefit, due to a provision in the Inflation Reduction Act of 2022. This analysis examines how many Medicare Part D enrollees spent $2,000 or more out of pocket in 2021 and over multiple years, both nationally and at the state level, to show how many people over time could benefit from the…

3 Charts: Medicare Drug Price Negotiations

Jan 31, 2024

News Release

Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). Part D covers retail prescription drugs and Part B covers physician-administered medications. This new requirement is the culmination of years of debate among lawmakers in Congress, and the Centers for…

10 Reasons Why Medicare Advantage Enrollment is Growing and Why It Matters

Jan 30, 2024

Issue Brief

This issue briefs lays out 10 reasons why Medicare Advantage enrollment has been growing and why we can expect more growth in the years to come.

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