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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Visualizing Health Policy: US Statistics on Surprise Medical Billing

This Visualizing Health Policy infographic looks at the experience of unexpected or “surprise” medical bills in the United States. Out-of-network charges typically expose individuals to higher cost-sharing when they use services, and may lead to balance billing – in which providers bill patients directly, and often unexpectedly, at a higher…

Health Issues and the Election Quiz

Test your knowledge about health facts, policy issues and proposals that are emerging among the 2020 presidential candidates. The 10 questions focus on health issues in the 2020 election, including: health care costs, prescription drug prices, the Affordable Care Act and changes in health insurance coverage, reproductive health, and Medicare-for-all and public option proposals.

Prescription Drugs

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…

Pricing and Payment for Medicaid Prescription Drugs

Attention to high list prices continues at both the state and federal levels with a number of policy proposals aimed at lowering drug prices and there is renewed interest in drug prices and reimbursement within Medicaid. Changes made in 2016 to federal rules governing how state Medicaid programs pay for drugs aimed to make the prices paid more accurate, but increased reliance on pharmacy benefit managers (PBMs) pose challenges to drug price transparency. This brief explains Medicaid prescription drug prices to help policymakers and others understand Medicaid’s role in drug pricing and any potential consequences of policy changes for the program.

Quick Look: Antiretroviral Price Increases in Medicare Part D

Drug price concerns in the U.S., including for antiretrovirals, the mainstay of HIV treatment and, increasingly prevention, have prompted the introduction of several policy proposals. One proposal would require manufacturers to provide a rebate to the federal government if prices increase faster than inflation. We assessed list price changes for ARVs under Part D, which is required to cover all or substantially all ARVs.

Management and Delivery of the Medicaid Pharmacy Benefit

States are limited in their leverage when it comes to controlling drug spending and use a variety of strategies to manage utilization, including an increased reliance on managed care and pharmacy benefit managers (PBMs). As policymakers debate proposals that include provisions related to Medicaid pharmacy benefits, it is important to understand the challenges state Medicaid programs face and how policy proposals may impact Medicaid beneficiaries and costs.