Prescription Drugs

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 2016 EHBS survey finds average family health premiums rose 3 percent in 2016, relatively modest growth by historical standards.

This chartpack presents a summary of Part D enrollment, premiums, cost sharing, benefit design and other key trends in 2016 and changes over time. For 2016, the analysis finds that 40% of Part D enrollees are now in Medicare Advantage drug plans, and over half of all enrollees are in plans offered by just three firms. The chartpack also highlights some concerning trends in the Low-Income Subsidy market, with the fewest number of premium-free plans available since Part D started, and 1.5 million LIS enrollees paying premiums for coverage, even though they have premium-free options available.

On Wednesday, September 7, from noon to 1 p.m. ET, the Kaiser Family Foundation hosted a web conversation to discuss trends in Medicare prescription drug spending, as well as proposals to reduce costs and forecasts of what beneficiaries can expect in coming years.

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.

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman uses new polling to explore why painkiller abuse and addiction is rising as a health issue among state and federal policymakers. All previous columns by Drew Altman are available online.

In this column for The Wall Street Journal’s Think Tank, Drew Altman uses new polling to explore why painkiller abuse and addiction is rising as a health issue among state and federal policymakers.

During the Medicare open enrollment period, beneficiaries have the opportunity to enroll in a plan that provides Part D prescription drug coverage, either a stand-alone prescription drug plan (PDP) to supplement traditional Medicare, or a Medicare Advantage drug plan. This issue brief provides an overview of the 2016 PDP marketplace, focusing on key changes from 2015, based on analysis of data from the Centers for Medicare & Medicaid Services. It presents analysis of PDP availability, premiums, benefit design, and low-income subsidy plans.

Since 2006, Medicare beneficiaries have had access through Medicare Part D to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Now in its tenth year, Part D has evolved due to changes in the private plan marketplace and the laws and regulations that govern the program. This report presents findings from an analysis of the Medicare Part D marketplace in 2015 and changes in features of the drug benefit offered by Part D plans since 2006.

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the trends that may be leading to a rise in consumer cost issues on the health agenda. All previous columns by Drew Altman are available online.

In this column for The Wall Street Journal’s Think Tank, Drew Altman examines the trends that may be leading to a rise in consumer cost issues on the health agenda.