Prescription Drugs - Research and Data from KFF

Analysis Finds 14 Million Medicare Part D and Large Employer Plan Enrollees Used Mail-Order Pharmacies Pre-Pandemic, Top Drugs Filled Were to Treat Chronic Conditions

Aug 20, 2020

News Release

With questions being raised about potential delays in U.S. Postal Service delivery, a new KFF data note estimates 14 million enrollees in Medicare Part D and large employer plans relied on mail-order pharmacies for at least one prescription in 2018, with a total of over 170 million prescriptions fulfilled. The use of mail-order pharmacies has been rising in recent years as patients have often been incentivized or mandated to use mail service for convenience and…

Mail Delays Could Affect Mail-Order Prescriptions for Millions of Medicare Part D and Large Employer Plan Enrollees

Aug 20, 2020

Issue Brief

Potential changes in mail service delivery could be a concern for people who receive prescription drugs from mail-order pharmacies. To understand who may be most affected by delays in the delivery of prescription drugs, we analyzed use of mail order in Medicare Part D and large group employer plans, and identified the therapeutic classes and specific drugs with the highest volume of fills by mail-order pharmacies in each market.

Health Affairs Article: Medicare Part D Plans Rarely Cover Brand-Name Drugs When Generics Are Available

Aug 10, 2020

Issue Brief

In an article in Health Affairs, KFF's Juliette Cubanski, Sarah True and Tricia Neuman, and several other co-authors, explore how often brand-name drugs receive favorable formulary inclusion relative to generics in the Medicare Part D program's prescription drug plans.

Medicaid Pharmacy Benefits State Fact Sheets

Aug 6, 2020

Interactive

These state fact sheets offer a snapshot of the administration and delivery of Medicaid pharmacy benefits in each state.

State Medicaid Management of Prescription Drugs for HIV Treatment and Prevention

Jun 4, 2020

Issue Brief

This data note, primarily based on a survey of state Medicaid pharmacies, reviews cost-containment policies and protections as they relate to antiretrovirals for treatment and prevention of HIV.

Insulin Costs and Coverage in Medicare Part D

Jun 4, 2020

Issue Brief

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.

States are Shifting How They Cover Prescription Drugs in Response to COVID-19

Apr 30, 2020

Policy Watch

Medicaid beneficiaries, particularly those with chronic conditions, will need access to medications even during social distancing and their ability to meet with providers to obtain refills may be hindered. States are updating policies to allow beneficiaries to access medications during this public health emergency.

How State Medicaid Programs are Managing Prescription Drug Costs: Results from a State Medicaid Pharmacy Survey for State Fiscal Years 2019 and 2020

Apr 29, 2020

Report

This report summarizes results from a Medicaid pharmacy benefit survey of all 50 states and the District of Columbia (DC) conducted by Kaiser Family Foundation and Health Management Associates in 2019.

Examining Medicare Part D Policies for Extended Supplies of Medication

Apr 1, 2020

Issue Brief

Medicare Part D plan sponsors, which provide drug coverage to 45 million older adults and people with disabilities, have the option to relax their ‘refill too soon’ restrictions in response to the COVID-19 pandemic, as part of efforts to ensure adequate access to medications in disasters or emergencies. This analysis examines the share of Part D enrollees who currently have access to extended supplies of generic, brand-name, and specialty-tier drugs covered by their plan in…

Retail Sales for Prescription Drugs Filled at Pharmacies by Payer

Mar 5, 2020

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