Prescription Drugs - Research and Data from KFF

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

Oct 11, 2019

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…

Medicare Beneficiaries Spent an Average of $5,460 Out-of-Pocket for Health Care in 2016, With Some Groups Spending Substantially More

Nov 4, 2019

News Release

The average person with traditional Medicare coverage paid $5,460 out of their own pocket for health care in 2016, according to a new KFF analysis and interactive tool. This $5,460 includes about $1,000 in out-of-pocket spending for long-term care facility services, averaged across all traditional Medicare beneficiaries. Such services are used by only 5 percent of beneficiaries in traditional Medicare. For the 95 percent of beneficiaries living in the community, average out-of-pocket spending on health…

Millions of Medicare Part D Enrollees Face Increases in Premiums and Other Costs in 2020 if They Do Not Switch Plans During Open Enrollment

Nov 14, 2019

News Release

Millions of current enrollees in stand-alone Medicare Part D prescription drug plans will face premium and other cost increases next year unless they switch to lower-cost plans during the open enrollment period that began Oct. 15 and ends on Dec. 7, a new KFF analysis finds. This includes two-thirds of Part D stand-alone drug plan enrollees not receiving low-income subsidies—nine million enrollees—who will face higher monthly premiums if they keep their current plan in 2020.…

Drug Overdose Deaths Have Declined Nationally and in Most States, Though Some States Have Seen Increases

Feb 6, 2020

Feature

While drug overdose deaths have declined nationally and in most states, 19 states have seen increases since 2017.

Visualizing Health Policy: US Statistics on Surprise Medical Billing

Feb 11, 2020

News Release

This Visualizing Health Policy infographic looks at the experience of unexpected or “surprise” medical bills in the United States. Out-of-network charges typically expose individuals to higher cost-sharing when they use services, and may lead to balance billing – in which providers bill patients directly, and often unexpectedly, at a higher rate. In the past two years, one in five insured adults had an unexpected medical bill from an out-of-network provider. Overall, two-thirds of adults are…

FAQs on Prescription Drug Importation

Mar 11, 2024

Issue Brief

These FAQs address questions related to prescription drug importation, including the current status of importation proposals, details of Florida’s importation program recently authorized by the FDA, and concerns and challenges with this approach.

Most Antiretrovirals Covered by Medicare Part D (as of 2017) Are Brand-Name, Single Source Medications

Dec 18, 2019

Feature

Most ARVs Covered by Medicare Part D are Brand Single Source Download

Among the 10 Antiretrovirals with the Highest Part D Spending in 2017, All Had List Price Increases Exceeding Inflation

Dec 18, 2019

Feature

All 10 Part D ARVs w Highest Spending Had Price Increases Above Inflation Download

Among the Most Commonly Used Antiretrovirals Covered by Part D in 2017, 9 of 10 Had List Prices Exceeding Inflation

Dec 18, 2019

Feature

9 of 10 Most Commonly Used ARVs in Part D Had List Prices Above Inflation Download

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.

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