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.
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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This data note summarizes our most recent polling on the public’s experiences with and worries about health care costs, and it highlights where Americans place costs on their list of health care issues for the government to address and for political candidates to discuss.
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…
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.
These FAQs provide background on prescription drug importation, including how the U.S. currently regulates importation and why it hasn’t been successfully implemented before. These FAQs also describe the newest importation proposals, both by the Trump Administration and at the state level, how these proposals seek to address concerns with prior proposals, and how stakeholders are viewing these newest proposals
In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.
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.