Medicare Part D

With the Biden administration’s announcement of the first 10 drugs to be negotiated for Medicare as part of the Inflation Reduction Act (IRA), an array of legal challenges from the pharmaceutical industry is potentially the biggest obstacle to implementation. In court filings, individual drugmakers and the industry’s main lobbying group…

As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF’s Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.

New weight loss drugs, such as Novo Nordisk’s Ozempic and Wegovy (semaglutide) and Eli Lilly’s Mounjaro (tirzepatide), could be transformative for people who struggle with obesity and obesity-related medical conditions, but there are major questions to consider related to insurance coverage, the cost of the drugs, and who has access.…

About half of adults are interested in taking prescription weight loss drugs. though interest drops when presented with obstacles or drawbacks. Many adults struggle with affording prescription drugs and say there should be more price regulation. Few are aware of provisions in the 2023 Inflation Reduction Act aimed at lowering the drug price for Medicare beneficiaries

The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment and costs in 2023 and trends over time. The analysis highlights the substantial growth of Medicare Advantage drug plans in the marketplace for Part D drug coverage, where enrollment overall is concentrated in a handful of large plan sponsors.

A new KFF analysis finds that the 10 top-selling prescription drugs under Medicare Part D comprised less than 1 percent of all covered drugs in 2021, but accounted for 22 percent, or $48 billion, of gross Medicare Part D drug spending that year. The analysis provides context for understanding the…

The Inflation Reduction Act requires the federal government to negotiate the price of certain high-spending drugs covered by Medicare. This analysis provides context for understanding the potential impact of negotiating prices for a limited number of Medicare-covered drugs by identifying the 10 top-selling Part D drugs in 2021, measuring the share of total Part D drug spending accounted for by top-selling drugs that year, and examining changes in spending and use of these drugs since 2018.

Two new KFF analyses examine the potential impact of Medicare coverage of new prescription drugs for obesity and Alzheimer’s disease on program spending and beneficiary out-of-pocket costs, as well as the role that the Inflation Reduction Act could play in mitigating these effects. Manufacturers of both types of drugs are…

In this piece, we discuss Medicare coverage of obesity treatments, the potential cost implications if Medicare covers anti-obesity drugs, and how the Inflation Reduction Act could potentially address these cost concerns.