In response to higher drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing Medicare to negotiate the price of prescription drugs. This issue brief provides a short history of this proposal, describes several bills introduced in the 116th Congress to allow government negotiations as well as assessments of potential savings from the Congressional Budget Office (CBO), and considers the prospects for action in the future.
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
- What Are Recent Trends and Characteristics of Workers with High Drug Spending?
- 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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List Prices Increased As Much As 9 Times Faster Than Inflation for 20 of the Top 25 Part D Drugs, Suggesting Potential for Savings Under Proposed Inflation Rebate Policies
A new KFF analysis finds that the list prices for most of the top Medicare Part D drugs by total spending increased as much as nine times the rate of inflation (1.7%) between 2016 and 2017, suggesting recent Congressional proposals targeting such increases could generate savings for Medicare and Part…
Explainer Video Breaks Down Prescription Drug Rebates and Why They Matter in the Debate About Prescription Drug Costs
A new KFF animation explains how rebates for prescription drugs work, including how they are determined, who benefits from them, how they affect spending by insurers and consumers and the role of pharmacy benefit managers in the process. The Trump Administration had proposed banning such rebates in Medicare Part D,…
The Medicare open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. This analysis examines the extent to which Medicare Advantage enrollees change plans when given the opportunity. It also analyzes the variation in the rate of plan switching by enrollee and plan characteristics and whether people who voluntarily switch plans tend to move to plans with lower premiums, lower out-of-pocket limits, or higher quality ratings.
With increased national attention towards prescription drug costs, this poll examines the public’s experiences with prescription medicine and their views on current policy proposals brought forth by congressional lawmakers and the Trump administration, including international reference pricing, transparency in drug advertisements, and negotiations with drug companies. The survey also dives into the attitudes and experiences of adults, 65 and older – a group that is more likely to report taking prescription medication and shopped for prescription drug coverage.
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.
Medicare Beneficiaries Spent an Average of $5,460 Out-of-Pocket for Health Care in 2016, With Some Groups Spending Substantially More
The average person with traditional Medicare coverage paid $5,460 out of their own pocket for health care in 2016, according to a new KFF analysis and interactive tool. This $5,460 includes about $1,000 in out-of-pocket spending for long-term care facility services, averaged across all traditional Medicare beneficiaries. Such services are…
Millions of Medicare Part D Enrollees Face Increases in Premiums and Other Costs in 2020 if They Do Not Switch Plans During Open Enrollment
Millions of current enrollees in stand-alone Medicare Part D prescription drug plans will face premium and other cost increases next year unless they switch to lower-cost plans during the open enrollment period that began Oct. 15 and ends on Dec. 7, a new KFF analysis finds. This includes two-thirds of…
In response to higher drug spending growth and heightened attention to drug prices, policymakers have proposed a variety of policy initiatives to lower the cost of prescription drugs in Medicare. This brief examines in detail the range of proposals offered by the Trump Administration and members of Congress for lowering the cost of prescription drugs, their known effects on the federal budget, and their potential implications for beneficiaries and other stakeholders.
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.