Proposals to allow the federal government to negotiate prescription drug prices, such as H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, aim to lower out-of-pocket drug costs for Medicare beneficiaries and private plan enrollees and achieve savings for Medicare. This data note estimates average premium savings attributable to the negotiations provision of H.R. 3 on a per capita basis for Part D enrollees who pay premiums in dollar amounts and as a share of the base beneficiary premium, based on aggregate premium reductions and baseline premiums projected by Medicare’s actuaries through 2029.
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
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.
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Related Prescription Drugs Resources
- Dec. 8 Event: Unpacking the Prescription Drug Provisions of the Build Back Better Act
- What Are the Key Prescription Drug Provisions in 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
- Relatively Few Drugs Account for a Large Share of Medicare Prescription Drug Spending
- FDA’s Approval of Biogen’s New Alzheimer’s Drug Has Huge Cost Implications for Medicare and Beneficiaries
- 10 FAQs on Prescription Drug Importation
- Insulin Costs and Coverage in Medicare Part D
- Medicaid Outpatient Prescription Drug Trends During the COVID-19 Pandemic
- An Overview of the Medicare Part D Prescription Drug Benefit
- Prescription Drug Rebates, Explained
- Who is most likely to have high prescription drug costs?
- Latest News on Prescription Drugs from Kaiser Health News
This charticle draws on recent KFF poll findings to provide an in-depth look at the public’s attitudes toward prescription drugs and their prices. Results include Americans’ opinions on drug affordability, pharmaceutical companies, and various potential measures that could lower prices.
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These FAQs discuss recent efforts related to prescription drug importation, the history of this approach, challenges that previous efforts to carry out importation proposals have faced, and stakeholder views.
Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Costs High Enough to Exceed the Catastrophic Threshold Over Time
Nearly 3 million Medicare Part D enrollees had out-of-pocket drug spending above the catastrophic threshold in a recent five-year period, finds a new KFF analysis that takes a comprehensive look at how many people on Medicare have drug expenses high enough to push them above that limit. While the Part…
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.
Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on the total amount that beneficiaries have to pay out of pocket each year. Policymakers on both sides of the aisle support proposals to modify the design of the Part D benefit and establish a hard cap on out-of-pocket prescription drug spending by Part D enrollees. This analysis shows the number of Part D enrollees without low-income subsidies who have exceeded the catastrophic coverage threshold annually, and over multiple years, based on 2007-2019 Part D claims data.
The brief examines the potential impact of Aduhelm, a newly approved drug for Alzheimer’s disease, on state and federal Medicaid costs and looks at potential policy actions that could limit Medicaid’s potential costs.
In this Axios column, Drew Altman looks beyond Medicare to what’s at stake for employers and workers in the debate about the government negotiating drug prices.
This brief analyzes leading federal approaches to address Medicaid prescription drug spending, discusses (where available) a range of cost estimates for each policy, and assesses what drives those estimates or where there is uncertainty in them.
FDA’s Approval of Biogen’s New Alzheimer’s Drug Has Huge Cost Implications for Medicare and Beneficiaries
The question of what would happen when a new, expensive prescription drug comes to market for a disease like Alzheimer’s that afflicts millions of people has loomed large in discussions over drug prices in the U.S. This brief analyzes the cost implications for Medicare and beneficiaries associated with Biogen’s new FDA-approved Alzheimer’s drug, which will cost $56,000 per year.
Prescription drug spending in Medicaid and other health programs has returned to the national policy debate. This analysis examines Medicaid outpatient prescription drug utilization and spending before rebates over the 2015 to 2019 period, which is helpful for understanding recent cost drivers and areas for targeted policy action.