This analysis of insurance claims data finds that Congressional proposals to set a $35 per month cap on what people pay out of pocket for insulin would provide financial relief to at least 1 out of 5 insulin users with different types of private health insurance.
Amid heightened public concern, the cost of prescription drugs is a focus of attention by the Biden administration and lawmakers in Congress and state capitals. Proposed actions range from allowing Medicare to negotiate the prices of certain drugs to limiting some drug price increases to inflation and capping out of pocket costs for Medicare beneficiaries in Part D, among other initiatives. See KFF’s research, analysis and public opinion data, as well as Kaiser Health News’ journalism, related to prescription drugs and their costs.
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Related Prescription Drugs Resources
- Insulin Out-of-Pocket Costs in Medicare Part D
- Prices Increased Faster Than Inflation for Half of all Drugs Covered by Medicare in 2020
- Out-of-pocket spending on insulin among people with private insurance
- How Do Prescription Drug Costs in the United States Compare to Other Countries?
- Public Opinion on Prescription Drugs and Their Prices
- Insulin Costs and Coverage in Medicare Part D
- Dec. 8 Event: Unpacking the Prescription Drug Provisions of the Build Back Better Act
- The Public Weighs In On Medicare Drug Negotiations
- Potential Savings for Medicare Part D Enrollees Under Proposals to Add a Hard Cap on Out-of-Pocket Spending
- Medicare Part B Drugs: Cost Implications for Beneficiaries in Traditional Medicare and Medicare Advantage
- 10 FAQs on Prescription Drug Importation
- Medicaid Outpatient Prescription Drug Trends During the COVID-19 Pandemic
- Prescription Drug Rebates, Explained
- Who is most likely to have high prescription drug costs?
- Latest News on Prescription Drugs from Kaiser Health News
How Would the Prescription Drug Provisions in the Senate Reconciliation Proposal Affect Medicare Beneficiaries?
The brief provides a quick explainer of the prescription drug provisions in legislative text released by the Senate Finance Committee to be included in a forthcoming reconciliation bill and presents new estimates on how many Medicare beneficiaries could be helped by those provisions.
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Medicare Part B Drugs: Cost Implications for Beneficiaries in Traditional Medicare and Medicare Advantage
In the face of rising prescription drug costs, a large majority of the public supports federal efforts to lower drug spending. Policymakers are considering several proposals that would lower prescription drug costs. To better understand the potential out-of-pocket cost exposure that Medicare beneficiaries may face for Part B drugs, which are typically administered by physicians and other health care providers, we analyzed cost-sharing liability for these drugs in traditional Medicare and cost-sharing requirements in Medicare Advantage plans.
Recent legislation would require drug companies to pay rebates to the federal government when annual increases in prescription drug prices for Medicare and private insurance exceed the rate of inflation. As context for understanding the possible impact of this proposal, this analysis compares price changes for drugs covered by Medicare Part B (administered by physicians) and Part D (retail prescription drugs) between 2019 and 2020 to the inflation rate over the same period.
Millions of Medicare Beneficiaries Use Prescription Drugs That Could Be Subject to Price Negotiation, But Build Back Better Act Provision Exempts Many Drugs With High Federal Spending
Twenty drugs and dozens of insulin products used by 8.5 million Medicare beneficiaries would be subject to government drug price negotiation if the Build Back Better Act (BBBA) were enacted and fully implemented in 2022, according to a new KFF analysis. The 20 drugs include 18 drugs available to beneficiaries…
The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal government to negotiate the price of some prescription drugs covered under Medicare Part B (administered by physicians) and Medicare Part D (retail outpatient drugs). This brief illustrates the potential scope of the drug price negotiation proposal in the BBBA. This analysis is designed to highlight the types of Medicare-covered drugs that could be subject to negotiation, and which of the current top-spending drugs covered by Part B and Part D could be subject to price negotiation, and in what years, if the BBBA is enacted.
Why Medicare’s Aduhelm Coverage Decision Could Increase Pressure on Officials to Roll Back the Record Part B Premium Increase for 2022
In a new Policy Watch, KFF experts explain why Medicare’s preliminary decision to cover a new Alzheimer’s drug only for a limited group of beneficiaries is likely to intensify pressure on officials to reconsider the increase in the Medicare Part B premium for 2022. Earlier this week, CMS issued a…
This policy watch discusses the implications of Medicare’s preliminary National Coverage Determination for the new Alzheimer’s drug, Aduhelm, on the 2022 Medicare Part B premium and the possibility of an adjustment based on the coverage decision. The piece also discusses the implications for Medicare spending and the connection to ongoing policy discussions around prescription drug proposals in the Build Back Better Act.
This data note describes Medicaid prescription drug utilization and spending trends in calendar year 2020 compared to previous years to explore how the pandemic impacted Medicaid prescription drug utilization and spending.
As the Build Back Better Act shifts from the House to the Senate, there’s considerable interest in provisions that would lower the cost of prescription drugs. The House-passed bill would allow the federal government to negotiate prices for some high-cost drugs in Medicare, and set a hard cap on out-of-pocket…