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This brief examines how Part D enrollees’ access to and utilization of the first set of 10 selected drugs could be affected by the new Part D coverage and formulary requirements for selected drugs established by the Inflation Reduction Act and in CMS guidance, as well as the potential for lower out-of-pocket costs.
In addition to having the highest obesity rates, the U.S is currently facing significantly higher prices for several major drugs used for weight loss and other health needs, according to a new KFF analysis of the list prices for semaglutide and tirzepatide drugs.
In the midst of an opioid epidemic in the United States, two-thirds of adults say either they or a family member have been impacted by drug or alcohol addiction. Three in ten say they or their family were addicted to prescription or illegal opioids. This survey explores treatments received by those who battled addiction, impacts of addiction, and support for policies aimed at reducing drug overdoses.
Nearly half (45%) of the public are at least somewhat interested in taking a prescription weight-loss drug, including many who say they only want to lose a little weight, though many people lose interest when presented with potential financial and medical drawbacks, the latest KFF Health Tracking Poll reveals.
This policy watch discusses some of the potential implications of the new anti-obesity drugs for racial equity.
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment and costs in 2023 and trends over time. The analysis highlights the substantial growth of Medicare Advantage drug plans in the marketplace for Part D drug coverage, where enrollment overall is concentrated in a handful of large plan sponsors.
In response to prescription drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing the federal government to negotiate the price of prescription drugs for Medicare and private payers. This brief describes the current status of drug price negotiation proposals, looks back at the history of proposals to give the federal government the authority to negotiate drug prices in Medicare, describes the negotiation provisions in key legislation (H.R. 3), and discusses the potential spending effects for the federal government, beneficiaries, and private payers.
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on the total amount that beneficiaries have to pay out of pocket each year. Policymakers on both sides of the aisle support proposals to modify the design of the Part D benefit and establish a hard cap on out-of-pocket prescription drug spending by Part D enrollees. This analysis shows the number of Part D enrollees without low-income subsidies who have exceeded the catastrophic coverage threshold annually, and over multiple years, based on 2007-2019 Part D claims data.
In this Axios column, Drew Altman looks beyond Medicare to what’s at stake for employers and workers in the debate about the government negotiating drug prices.
This brief analyzes leading federal approaches to address Medicaid prescription drug spending, discusses (where available) a range of cost estimates for each policy, and assesses what drives those estimates or where there is uncertainty in them.
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