Amid heightened public concern, the cost of prescription drugs is a focus of attention by the Biden administration and lawmakers in Congress and state capitals. Proposed actions range from allowing Medicare to negotiate the prices of certain drugs to limiting some drug price increases to inflation and capping out of pocket costs for Medicare beneficiaries in Part D, among other initiatives. See KFF’s research, analysis and public opinion data, as well as Kaiser Health News’ journalism, related to prescription drugs and their costs.
Featured Prescription Drugs Resources
Out-of-pocket spending on insulin among people with private insurance
This analysis of insurance claims data finds that Congressional proposals to set a $35 per month cap on what people pay out of pocket for insulin would provide financial relief to at least 1 out of 5 insulin users with different types of private health insurance.
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Related Prescription Drugs Resources
- Public Opinion on Prescription Drugs and Their Prices
- Insulin Costs and Coverage in Medicare Part D
- Prices Increased Faster Than Inflation for Half of all Drugs Covered by Medicare in 2020
- Dec. 8 Event: Unpacking the Prescription Drug Provisions of the Build Back Better Act
- The Public Weighs In On Medicare Drug Negotiations
- Potential Savings for Medicare Part D Enrollees Under Proposals to Add a Hard Cap on Out-of-Pocket Spending
- Medicare Part B Drugs: Cost Implications for Beneficiaries in Traditional Medicare and Medicare Advantage
- 10 FAQs on Prescription Drug Importation
- Medicaid Outpatient Prescription Drug Trends During the COVID-19 Pandemic
- Prescription Drug Rebates, Explained
- Who is most likely to have high prescription drug costs?
- Latest News on Prescription Drugs from Kaiser Health News
How Do Prescription Drug Costs in the United States Compare to Other Countries?
This chart collection examines what we know about prescription drug spending and use in the U.S. and comparably large and wealthy countries, using data from the Organization for Economic Cooperation and Development (OECD).
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Medicare Part D: A First Look at Prescription Drug Plans in 2018
This issue brief provides an overview of the 2018 Medicare Part D stand-alone prescription drug plan landscape, the largest segment of the Part D marketplace, 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 top ten Part D plans in 2018.
Issue Brief Read More To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans To Save Money?
This analysis finds that relatively few Medicare beneficiaries have switched Part D prescription drug plans voluntarily during the annual open enrollment period — even though those who do switch often lower their out-of-pocket costs as a result of changing plans. The vast majority (87% on average between 2006 and 2010) stayed in the same Part D plan, even though the plans can change premiums, deductibles, cost-sharing amounts, and their list of covered drugs each year. Higher rates of plan switching were observed in PDPs that increased premiums, increased deductibles, or dropped coverage of brand-name drugs in the coverage gap.
Issue Brief Read More Medicare Part D: A First Look at Plan Offerings in 2014
The 2014 Part D Data Spotlight analyzes information about the Medicare Part D stand-alone prescription drug plan (PDP) options available to beneficiaries in 2014. The analysis shows that Medicare beneficiaries on average will have a choice of 35 stand-alone prescription drug plans in 2014, and somewhat more “benchmark” plans available to Low-Income Subsidy (LIS) beneficiaries nationwide. The weighted average premium will increase by 5 percent between 2013 and 2014 if enrollees remain in the same plans next year. The analysis also finds more plans are using preferred pharmacy networks and adopting a growing number of cost-sharing formulary tiers for different drugs.
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It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016
This analysis focuses on out-of-pocket drug costs for Medicare Part D enrollees in 2016 for specialty, brand, and generic drugs. Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be substantial. In addition to examining costs for common drugs, we also examine profiles of multiple drugs for several hypothetical Part D enrollees.
Issue Brief Read More Americans’ Health Priorities Diverge From Washington’s Focus on Obamacare
In his latest column for The Wall Street Journal’s Think Tank, Drew Altman finds the public’s health-care priorities have more to do with drug costs and other real-world issues people deal with using the health-care system than the ongoing partisan wrangling over the Affordable Care Act. All previous columns by Drew Altman are available…
News Release Read More A Primer on Medicare: Key Facts About the Medicare Program and the People it Covers
This primer explains key elements of the Medicare program, which now provides health coverage to 55 million people — including 46 million people age 65 and older and another 9 million younger adults with permanent disabilities. It looks at the characteristics of the Medicare population, what benefits are covered, how much people with Medicare pay for their benefits and the program’s overall costs and future financing challenges.
Report Read More 2013 Employer Health Benefits Survey
This annual Employer Health Benefits Survey (EHBS) provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The 2013 EHBS survey finds average family health premiums rose 4 percent in 2013, relatively modest growth by historical standards.
Report Read More Paying for Prescribed Drugs in Medicaid: Current Policy and Upcoming Changes
The federal government has proposed new rules that aim to make Medicaid outpatient drug reimbursement policies more closely match the cost of obtaining and filling prescriptions. However, the change in policy may have varying effects on reimbursement, depending on the state’s current approach and the type of drug in question. This paper explains current Medicaid pharmacy reimbursement methodology and examines the potential effect of the proposed rule changes.
Issue Brief Read More Medicare Part D: A First Look at Plan Offerings in 2015
This issue brief provides an overview of the Medicare Part D stand-alone prescription drug plan options available in 2015 and key changes from prior years. The analysis examines Part D plan availability, premiums, benefit design features, and low income subsidy plan availability.
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