Out-of-pocket spending on insulin among people with private insurance March 24, 2022 Issue Brief 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.
Medicare Part B Drugs: Cost Implications for Beneficiaries in Traditional Medicare and Medicare Advantage March 15, 2022 Issue Brief 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.
Prices Increased Faster Than Inflation for Half of all Drugs Covered by Medicare in 2020 February 25, 2022 Issue Brief 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.
How Do Prescription Drug Costs in the United States Compare to Other Countries? February 8, 2022 Slideshow
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 January 27, 2022 News Release 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…
Simulating the Impact of the Drug Price Negotiation Proposal in the Build Back Better Act January 27, 2022 Issue Brief 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 January 14, 2022 News Release 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…
Medicare’s Coverage Decision for the New Alzheimer’s Drug and Why It Matters January 14, 2022 Blog 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.
Monthly Part B Premiums and Annual Percentage Increases January 12, 2022 Slide The $21.60 increase in 2022 is the largest in dollar terms since the start of the program, even though premiums have risen faster in percentage terms on three other occasions in the last 20 years
Medicaid Outpatient Prescription Drug Trends During the COVID-19 Pandemic December 14, 2021 Issue Brief 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.