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Amid heightened public concern, the cost of prescription drugs is the focus of renewed attention by the Trump administration 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.

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The Henry J. Kaiser Family Foundation

Analysis Finds that Medications for Hepatitis C and HIV/AIDS Are the Costliest Group of Outpatient Prescription Drugs for Medicaid, While Diabetes Drugs Have Posted the Sharpest Rise in Costs 

Antiviral medications, including those that treat hepatitis C and HIV/AIDS, cost the Medicaid program more money (before rebates) than any other group of outpatient prescription drugs for each year from 2014 to 2017, according to a new KFF analysis. The analysis of utilization and spending trends finds that antivirals accounted…

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Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs

Although the outpatient drug benefit accounts for only 6% of total Medicaid spending, drug spending has increased by double digits in recent years, and is expected to grow faster than most other Medicaid services in the next 10 years. This issue brief examines drug spending and utilization from 2014 through 2017 by drug group, brand and generic status, and biologic status to understand the causes for this increase in spending.

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The Out-of-Pocket Cost Burden for Specialty Drugs in Medicare Part D in 2019

Medicare Part D has helped to make prescription drugs more affordable for people with Medicare, yet many beneficiaries continue to face high out-of-pocket costs for their medications. Specialty tier drugs are a particular concern for Part D enrollees in this context. This analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 out-of-pocket costs for 30 specialty tier drugs used to treat four health conditions—cancer, hepatitis C, multiple sclerosis, and rheumatoid arthritis.

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The Henry J. Kaiser Family Foundation

Medicare Part D Enrollees with Serious Health Conditions Can Face Thousands of Dollars in Out-of-Pocket Costs Annually for Specialty Drugs

Despite Medicare’s protections, Part D enrollees with serious health conditions can face thousands of dollars in annual out-of-pocket costs for expensive specialty drugs, a new KFF anaylsis finds. The analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 costs for more than two dozen specialty tier…

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Percent of total U.S. retail prescription drug spending by payer

10 Essential Facts About Medicare and Prescription Drug Spending

Prescription drugs play an important role in medical care for 60 million seniors and people with disabilities, and account for nearly $1 out of every $5 in Medicare spending. This chart series examines trends in Medicare and beneficiary out-of-pocket spending on prescription drugs, and what the public thinks about different options for keeping drug costs down.

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Initiative 18|11: What Can We Do About The Cost Of Health Care?

This conference report summarizes discussions at a March 2018 conference in Washington with 30 leaders from the health care community to launch Initiative 18/11, a partnership between the Society of Actuaries and KFF to address the rising cost of health care in the United States. It also lays out the next steps for the initiative.

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Cost-Sharing for Plans Offered in the Federal Marketplace for 2019

This analysis documents average deductibles and out-of-pocket limits for 2019 Affordable Care Act marketplace plans available on Healthcare.gov on all metal tiers, including silver plans after cost-sharing reductions are applied.

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KFF Health Tracking Poll – November 2018: Priorities for New Congress and the Future of the ACA and Medicaid Expansion

Fielded a week after the 2018 midterm elections, this poll examines the public’s priorities for the next Congress, measures favorability for ACA provisions including Medicaid expansion, and takes a look at knowledge of the current open enrollment period among adults ages 18-64 who purchase their own insurance or are currently uninsured. With the impending Texas v. United States lawsuit, in addition to several Trump administration policy actions aimed at different aspects of the U.S. health care system, this KFF survey also examines the public’s position on pre-existing conditions protections, prescription drug advertisements, and employer exemptions from covering birth control.

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The Henry J. Kaiser Family Foundation

Bipartisan Majorities Support Trump Administration’s Push to Get Drug Prices in Advertisements, Even after Hearing Counter-Arguments

Only 1 in 4 Potential Marketplace Customers Know When ACA Open Enrollment Ends; 1 in 5 Say They Would Buy a Short-Term Plan A large majority of the public backs the Trump Administration’s initiative to require prescription drug advertisements to include information about prices, but fewer support other administrative actions…

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States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019

This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia. This report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019 (which began for most states on July 1, 2018). Key areas covered include changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

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