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Prescription drug costs are a pressing concern for both consumers and policymakers. This analysis compares prescription drug spending and use in large private employer plans, Medicare Part D, and Medicaid, based primarily on claims data by payer, which does not account for rebates.
The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total Medicare spending by billions of dollars over a decade.
Out-of-pocket insulin costs for Medicare Part D enrollees with incomes too high to qualify for low-income subsidies increased 81% from 2007 to 2016. Learn more in the latest Chart of the Week.
Medicare Part D spending on insulin increased 840 percent between 2007 and 2017, far outpacing growth in the number of beneficiaries using insulin therapy, according to a new KFF analysis.
The price of insulin, used by people with both Type 1 and Type 2 diabetes to control blood glucose levels, has come under increasing scrutiny as policymakers grapple with rising drug costs. This data note finds spending on insulin by Medicare and beneficiaries enrolled in private Part D drug plans has increased sharply between 2007 and 2017.
As the Trump Administration and Congress weigh policy options to address high prescription drug prices, a fourth of people taking prescription drugs (24%) and seniors taking drugs (23%) say it is difficult for them to afford their medications, the latest KFF Health Tracking Poll finds.
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.
Antiviral medications, including those that treat hepatitis C and HIV/AIDS, cost the Medicaid program more money (before rebates) than any other group of outpatient prescription drugs for each year from 2014 to 2017, according to a new KFF analysis.
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 Part D has helped to make prescription drugs more affordable for people with Medicare, yet many beneficiaries continue to face high out-of-pocket costs for their medications. Specialty tier drugs are a particular concern for Part D enrollees in this context. This analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 out-of-pocket costs for 30 specialty tier drugs used to treat four health conditions—cancer, hepatitis C, multiple sclerosis, and rheumatoid arthritis.
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