This brief examines how leading federal and state policy options related to changes in Medicaid Drug Rebate Program (MDRP), drug pricing, and payment and management of the Medicaid prescription drug would affect state and federal governments as well as private industry (including drug manufacturers, managed care organizations, and pharmacies).
Amid heightened public concern, the cost of prescription drugs is the focus of renewed attention by the Trump administration, the Biden campaign and lawmakers in Congress and state capitals. Proposed actions range from sweeping health care system changes to targeted initiatives that could affect Medicare, Medicaid and private insurance. 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
KFF Health Tracking Poll – October 2019: Health Care In The Democratic Debates, Congress, And The Courts
This poll examines health care issues in the Democratic presidential primary , government negotiation of prescription drug prices, party trust on health care, Medicare-for-all, and the pending Texas v. US lawsuit affecting the Affordable Care Act and pre-existing condition protections.
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Related Prescription Drugs Resources
- Assessing Drug Price Increases in Medicare Part D and the Implications of Inflation Limits
- 10 FAQs on Prescription Drug Importation
- Pricing and Payment for Medicaid Prescription Drugs
- Management and Delivery of the Medicaid Pharmacy Benefit
- Understanding the Medicaid Prescription Drug Rebate Program
- A Look at Recent Proposals to Control Drug Spending by Medicare and its Beneficiaries
- Kaiser Health News Coverage of Prescription Drug Issues
- What are the recent and forecasted trends in prescription drug spending?
- What’s the Latest on Medicare Drug Price Negotiations?
- How Will The Medicare Part D Benefit Change Under Current Law and Leading Proposals?
- Medicaid’s Prescription Drug Benefit: Key Facts
- Public Opinion on Prescription Drugs and Their Prices
- Prescription Drug Rebates, Explained
- Who is Most Likely to Have High Prescription Drug Costs?
- Snapshots of Recent State Initiatives in Medicaid Prescription Drug Cost Control
- 10 Essential Facts About Medicare and Prescription Drug Spending
- Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs
- How Does Prescription Drug Spending and Use Compare Across Large Employer Plans, Medicare Part D, and Medicaid?
What’s the Latest on Prescription Drug Proposals from the Trump Administration, Congress, and the Biden Campaign?
This slideshow explains the similarities and differences among major proposals to lower prescription drug costs introduced by the Trump Administration, members of Congress, and the Biden campaign.
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Analysis Finds That a Relatively Small Number of Drugs Account for the Majority of Medicare Prescription Drug Spending
A new KFF analysis finds that a relatively small share of drugs, mainly those without generic or biosimilar competitors, accounted for a disproportionate share of prescription drug spending in Medicare in 2019. This finding suggests that recent proposals that focus on prices for a limited number of high-cost drugs could…
As policymakers focus attention on proposals to lower prescription drug costs by allowing price negotiation or international reference pricing for a limited number of drugs, this analysis measures the share of total Medicare Part D and Part B prescription drug spending accounted for by top-selling drugs covered under each part.
Moving the Needle on Prescription Drug Costs: Using the Innovation Center and Other Demonstration Authority
This brief examines how the CMS Innovation Center (also known as CMMI) and Section 402 demonstration authority could become pathways for the Biden Administration to implement policy changes related to prescription drug costs.
A Status Report on Prescription Drug Policies and Proposals at the Start of the Biden Administration
This brief provides a status update on prescription drug final rules advanced by the Trump Administration in its final months related to Medicare, importation, and 340B pricing for insulin and epinephrine, and an overview of key drug pricing proposals related to Medicare and prescription drug prices generally that were voted on but not enacted in the previous Congress that may return to the forefront of health policy discussions in the coming years.
As context for understanding the rationale for efforts to limit drug price increases, this analysis compares changes in list prices for drugs covered by Medicare Part D in 2019 to the inflation rate, based on data from the most recent Medicare Part D drug spending dashboard from the Centers for Medicare & Medicaid Services (CMS).
With the inauguration of President Biden and Democrats holding a slim majority in Congress, policymakers are likely to consider whether and how to reverse various health policy regulations issued by the Trump Administration.
In this column for the JAMA Health Forum, Larry Levitt explores what President-elect Biden might do to advance his health care vision both through legislation and through executive orders and waivers and demonstrations.
As the U.S. prepares for nationwide distribution of vaccines to combat COVID-19, some are asking whether people who get the first of two doses will return to complete the series. This analysis draws on Medicare Part D prescription drug claims data for the herpes zoster vaccine Shingrix, which also requires two doses, to shed light on this potential challenge of the leading COVID-19 vaccine candidates.
This brief outlines the potential health policy actions that President Biden could take using executive authority, based on campaign pledges, and actions that would reverse or modify regulations or guidance issued by the Trump Administration.