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  • A Small Number of Drugs Account for a Large Share of Medicare Part D Spending

    Issue Brief

    The Inflation Reduction Act requires the federal government to negotiate the price of certain high-spending drugs covered by Medicare. This analysis provides context for understanding the potential impact of negotiating prices for a limited number of Medicare-covered drugs by identifying the 10 top-selling Part D drugs in 2021, measuring the share of total Part D drug spending accounted for by top-selling drugs that year, and examining changes in spending and use of these drugs since…

  • KFF News Release

    10 Prescription Drugs Accounted for $48 Billion in Medicare Part D Spending in 2021, or More Than One-Fifth of Part D Spending That Year  

    News Release

    A new KFF analysis finds that the 10 top-selling prescription drugs under Medicare Part D comprised less than 1 percent of all covered drugs in 2021, but accounted for 22 percent, or $48 billion, of gross Medicare Part D drug spending that year. The analysis provides context for understanding the federal government’s new authority under the Inflation Reduction Act to negotiate prices for some high-spending drugs covered by Part D, Medicare’s outpatient prescription drug benefit…

  • 3 Charts: Medicare Drug Price Negotiations

    News Release

    Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). Part D covers retail prescription drugs and Part B covers physician-administered medications. This new requirement is the culmination of years of debate among lawmakers in Congress, and the Centers for…

  • Initiative 18|11: What Can We Do About The Cost Of Health Care?

    Issue Brief

    This conference report summarizes discussions at a March 2018 conference in Washington with 30 leaders from the health care community to launch Initiative 18/11, a partnership between the Society of Actuaries and KFF to address the rising cost of health care in the United States. It also lays out the next steps for the initiative.

  • How Many Medicare Part D Enrollees Had High Out-of-Pocket Drug Costs in 2017?

    Issue Brief

    The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.

  • Explainer Video Breaks Down Prescription Drug Rebates and Why They Matter in the Debate About Prescription Drug Costs

    News Release

    A new KFF animation explains how rebates for prescription drugs work, including how they are determined, who benefits from them, how they affect spending by insurers and consumers and the role of pharmacy benefit managers in the process. The Trump Administration had proposed banning such rebates in Medicare Part D, but dropped the proposal amid concerns that it would lead to higher costs for insurers, consumers and the Medicare program. It is still possible that…

  • A Small Group of Patients Account for a Whole Lot of Spending

    From Drew Altman

    You have heard about the 5% of the population responsible for 50% of spending. Meet the 1.3%--persistent high spenders with very complex medical needs responsible for 20%. Drew Altman discusses this and possible ways to help them, read the Axios column.

  • Analysis Finds that Medications for Hepatitis C and HIV/AIDS Are the Costliest Group of Outpatient Prescription Drugs for Medicaid, While Diabetes Drugs Have Posted the Sharpest Rise in Costs 

    News Release

    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. The analysis of utilization and spending trends finds that antivirals accounted for more than 13 percent of the $63.6 billion in Medicaid outpatient drug spending pre-rebates in 2017 -- a level disproportionate to their utilization and…

  • Bipartisan Majorities Support Trump Administration’s Push to Get Drug Prices in Advertisements, Even after Hearing Counter-Arguments

    News Release

    Only 1 in 4 Potential Marketplace Customers Know When ACA Open Enrollment Ends; 1 in 5 Say They Would Buy a Short-Term Plan A large majority of the public backs the Trump Administration’s initiative to require prescription drug advertisements to include information about prices, but fewer support other administrative actions involving pre-existing conditions and contraception coverage, the latest KFF Health Tracking Poll finds. Requiring drugmakers to include price information in their advertisements is a widely…