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  • Medicare Part D Beneficiaries Who Reach the Catastrophic Coverage Limit Can Expect to Pay More Out-of-Pocket for Their Prescription Drugs Next Year

    News Release

    Medicare Part D enrollees with relatively high out-of-pocket expenses can expect see their costs rise in 2020, according to a new KFF analysis. This is mainly due to an increase in how much enrollees will pay out of pocket for their prescription drugs in the Part D benefit coverage gap phase before they qualify for catastrophic coverage. The analysis finds that out-of-pocket drug costs will increase by nearly $400 -- from $2,275 in 2019 to…

  • The IRA Has Improved Coverage of Drugs Selected for Medicare Price Negotiation

    Issue Brief

    The Medicare drug price negotiation program could improve coverage of drugs selected for negotiation for Medicare beneficiaries because the law requires all Medicare Part D plans to cover each of the selected drugs, including all dosages and forms, when negotiated prices take effect. This analysis examines 2026 Medicare Part D formulary coverage of drugs selected for negotiation to measure the effect of the IRA's coverage requirement.

  • Constrained Budgets Lead States to Restrict HIV Drug Access Through Ryan White

    Policy Watch

    States are facing constrained budgets, putting pressure on HIV programs, including the Ryan White HIV/AIDS Program. This Policy Watch explores how state Ryan White AIDS Drug Assistance Programs (ADAPs) are responding to these budget pressures, including by restricting eligibility and reducing the scope of services offered, actions that could led to negative health outcomes for people with HIV and lead to new HIV infections.

  • Analyzing Changes in Medicare Part D Enrollment for 2026

    Issue Brief

    The Medicare Part D prescription drug benefit is provided by private plans, either Medicare Advantage plans that offer drug coverage (MA-PDs) or, for those in traditional Medicare, stand-alone prescription drug plans (PDPs). New data from CMS shows that 56 million people are enrolled in Part D plans as of February 2026, with more in MA-PDs than PDPs, reflecting higher overall enrollment in Medicare Advantage than in traditional Medicare. Enrollment in group MA-PD plans decreased while…

  • Probing the Legal Arguments in the Drug Industry’s Challenges to Medicare Drug Price Negotiations

    Event Date:
    Event

    With the Biden administration’s announcement of the first 10 drugs to be negotiated for Medicare as part of the Inflation Reduction Act (IRA), an array of legal challenges from the pharmaceutical industry is potentially the biggest obstacle to implementation. On Tuesday, September 12, two legal experts and a health policy expert joined Larry Levitt, executive vice president for health policy at KFF, for a 45-minute discussion about the legal issues underpinning these lawsuits and how…

  • What Drives Health Spending in the U.S. Compared to Other Countries

    Issue Brief

    An updated issue brief looks at the drivers of health spending in the U.S. and key differences between the U.S. and other large, wealthy nations. The analysis finds that people in the U.S. spent $5,683 more per person on health care compared to those in similarly large and wealthy countries. Almost 80% of the difference in spending came from inpatient and outpatient care costs. Many retail prescription drugs also cost more in the U.S. In…

  • Prescriptions to Treat Opioid Overdoses and Opioid Use Disorder Among Medicaid Enrollees Rose Sharply in the Years Leading Up to the Pandemic

    News Release

    State Medicaid programs saw a doubling of prescriptions for medications used to treat Opioid Use Disorder (OUD) or rapidly reverse opioid overdoses from 2016 to 2019, finds a new KFF analysis. KFF analysts studied the latest available Medicaid claims data -- detailed and comprehensive administrative data that can help answer questions and inform policy -- and found that the share of enrollees who received at least one medication used to treat OUD or reverse opioid…

  • KFF Prescription Drug Advertisements Poll: January 2025

    Poll Finding

    KFF’s January 2025 Prescription Drug Advertisements Poll looks at the public's experiences with prescription drug advertisements, whether they've talked to a doctor about advertised drugs, and how this has influenced the care they receive.