In response to prescription drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing the federal government to negotiate the price of prescription drugs for Medicare and private payers. This brief describes the current status of drug price negotiation proposals, looks back at the history of proposals to give the federal government the authority to negotiate drug prices in Medicare, describes the negotiation provisions in key legislation (H.R. 3), and discusses the potential spending effects for the federal government, beneficiaries, and private payers.
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
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
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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Potential Savings for Medicare Part D Enrollees Under Proposals to Add a Hard Cap on Out-of-Pocket Spending
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides coverage above a catastrophic threshold for high out-of-pocket drug costs, but there is no cap on total out-of-pocket drug costs that beneficiaries pay each year. Recent legislative proposals would add a cap on out-of-pocket spending under Part D. This analysis focuses on the potential impact of different out-of-pocket spending caps in terms of how many beneficiaries would be affected and how much they could save.
This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year’s report also looks at how employers changed their mental health, telemedicine and other benefits in response to the COVID-19 pandemic.
The Build Back Better Act includes several provisions that would lower prescription drug costs for people with Medicare and private insurance and reduce drug spending by the federal government and private payers. This brief summarizes these provisions and discusses the expected effects on people, program spending, and drug prices and innovation.
Millions of Medicare Beneficiaries Use Prescription Drugs That Could Be Subject to Price Negotiation, But Build Back Better Act Provision Exempts Many Drugs With High Federal Spending
Twenty drugs and dozens of insulin products used by 8.5 million Medicare beneficiaries would be subject to government drug price negotiation if the Build Back Better Act (BBBA) were enacted and fully implemented in 2022, according to a new KFF analysis. The 20 drugs include 18 drugs available to beneficiaries…
This brief summarizes KFF’s most recent polling on the public’s experiences and challenges with health care costs, and it highlights the consequences of high health care costs on the uninsured and those with lower incomes.
This brief provides an overview of the tele-PrEP landscape, including how PrEP services (e.g., consults, lab work, prescribing, and monitoring) are provided and factors that facilitate its provision as well as barriers that remain. It is based on in-depth interviews with representatives from the major national telehealth companies providing tele-PrEP and other select tele-PrEP programs.
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…