What Are the Prescription Drug Provisions in the Inflation Reduction Act?
This slideshow explains the prescription drug provisions proposed in the Inflation Reduction Act as passed by the Senate
Medicare Part D
August 11 Web Event: Understanding the Health Care Provisions in the Inflation Reduction Act
The House is expected to take up the Senate-passed Inflation Reduction Act later this week, a sweeping bill that includes several landmark health care provisions […]
Specialty pharmacy serving HIV patients wins arbitration against CVS in rare public case
Confidentiality agreements typically prevent the public from obtaining a window into the cases against pharmacy behemoths but a public court filing makes this one different.
Findings from 2022 Medicare and Social Security Trustees Report
Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds came out with their annual report on the state […]
Insulin Out-of-Pocket Costs in Medicare Part D
Addressing the cost of insulin continues to be at the forefront of policy discussions around prescription drugs. This analysis describes out-of-pocket spending on insulin products […]
Financial hardship to afford prescription drugs over time: Evidence from 1998-2021
In the past, seniors in Medicare had to pay for all their prescription drugs out-of-pocket. For elderly individuals with multiple medical conditions, this lack of […]
Preferred Pharmacies in Medicare Part D
Medicare Part D plans have begun using preferred pharmacy networks in order to steer their beneficiaries to lower cost pharmacies. A key question is, does […]
State Profiles Highlight Variations in How Many Low-Income Medicare Beneficiaries Get Additional Help with Their Medicare Costs
Medicare beneficiaries with low incomes and modest assets can qualify for additional financial help with Medicare premiums and cost sharing through both the Medicare Savings […]
Help with Medicare Premium and Cost-Sharing Assistance Varies by State
This data note provides an overview of programs that help beneficiaries with most incomes with their Medicare costs, including the Medicare Savings Programs (which provide […]
Medicare State Profiles
These state profiles capture the variations across states in the number and characteristics of Medicare beneficiaries through the Medicare Savings Programs and Medicare’s Part D […]
Ending COVID-19 Emergency Declarations Will Bring an End to Flexibilities that Aided Patients, Providers, Insurers, and Public Programs in Responding to the Pandemic
When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several […]
What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access
With more than two years having passed since the COVID-19 pandemic began in early 2020, questions are being raised about when to end the public […]
What happened after the implementation of Medicare Part D coverage gap reform?
Since its inception in 2006, Medicare Part D beneficiaries had to contend with the dreaded “doughnut hole”. The “doughnut hole” is a coverage gap during […]
Prices Increased Faster Than Inflation for Half of all Drugs Covered by Medicare in 2020
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 […]
Simulating the Impact of the Drug Price Negotiation Proposal in the Build Back Better Act
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 […]
What Are the Key Prescription Drug Provisions in the Build Back Better Act?
This slideshow explains the latest prescription drug provisions in the Build Back Better Act (BBBA).
Summary of Costs and Impact of the Prescription Drug Provisions in the Build Back Better Act
As the House-passed Build Back Better Act moves to the Senate, a new explainer from KFF summarizes the key prescription drug provisions within the broader […]
Explaining the Prescription Drug Provisions in the Build Back Better Act
The Build Back Better Act includes several provisions that would lower prescription drug costs for people with Medicare and private insurance and reduce drug spending […]
A Record 3,834 Medicare Advantage Plans Will be Available in 2022, Up 8 Percent From 2021, While the Number of Medicare Part D Stand-Alone Plans is Decreasing Mainly Due to Firm Consolidations
A record 3,834 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare for 2022, a new KFF analysis finds. That’s […]
Medicare Advantage 2022 Spotlight: First Look
For 2022, the average Medicare beneficiary has access to 39 Medicare Advantage plans, the largest number of options available in the last decade, and can […]
Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2022
This issue brief provides an overview of the Medicare Part D prescription drug benefit market for 2022, with a primary focus on stand-alone drug plans. […]
Potential Costs and Impact of Health Provisions in the Build Back Better Act
A summary of 10 of the major health coverage and financing provisions of the original Build Back Better Act, with discussion of the potential implications […]
Part D Senior Savings Model: What is it?
If you are on Medicare, how much will you pay for insulin? The answer is in the graph below (via MedPAC’s Payment Basics) Seem confusing? […]
An Overview of the Medicare Part D Prescription Drug Benefit
This fact sheet includes the latest information and data about the Medicare Part D prescription drug benefit, including current plan information, the standard benefit parameters, […]
Potential Savings for Medicare Part D Enrollees Under Proposals to Add a Hard Cap on Out-of-Pocket Spending
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides coverage above a catastrophic threshold for high out-of-pocket drug costs, but there is […]
How Would Drug Price Negotiation Affect Medicare Part D Premiums?
Proposals to allow the federal government to negotiate prescription drug prices, such as H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, aim […]
Medicare vaccine coverage (including how the COVID-19 vaccines are covered)
How does Medicare cover vaccines? Are the paid for by Medicare Part B or Part D? MedPAC’s June 2021 report provides a nice overview. Medicare […]
Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Costs High Enough to Exceed the Catastrophic Threshold Over Time
Nearly 3 million Medicare Part D enrollees had out-of-pocket drug spending above the catastrophic threshold in a recent five-year period, finds a new KFF analysis […]
What’s the Latest on Medicare Drug Price Negotiations?
In response to prescription drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing the federal government to negotiate the price […]
Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on […]
Do most Medicare Part D drugs have CEA studies?
That is the question that a recent study by Tisdale et al. (2021) aim to answer. They first look at the top 250 Medicare Part […]
GAO report on prescription drug advertising
Medicare beneficiaries are largely elderly individuals, many of whom suffer from a variety of health conditions. Pharmaceutical manufacturers want these patients and their physicians to […]
Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2021
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private […]
Is drug competition bad for patients?
In general, you would think the answer is no. If there are multiple treatments available, patients have more choice. Further, the treatments may need to […]
The impact of filling the donut hole
Medicare Part D has a confusing benefit system. Prior to 2011, patients had a deductible, then a general coverage benefit (with 25% coinsurance) then a […]
Analysis Finds That a Relatively Small Number of Drugs Account for the Majority of Medicare Prescription Drug Spending
A new KFF analysis finds that a relatively small share of drugs, mainly those without generic or biosimilar competitors, accounted for a disproportionate share of […]
Relatively Few Drugs Account for a Large Share of Medicare Prescription Drug Spending
As policymakers focus attention on proposals to lower prescription drug costs by allowing price negotiation or international reference pricing for a limited number of drugs, […]
Moving the Needle on Prescription Drug Costs: Using the Innovation Center and Other Demonstration Authority
This brief examines how the CMS Innovation Center (also known as CMMI) and Section 402 demonstration authority could become pathways for the Biden Administration to […]
How much does the U.S. federal government pay for pharmaceuticals?
A number of different federal agencies buy prescription drugs. However, the price at which these pharmaceuticals are purchased varies dramatically. To quantify this variation, a […]
A Status Report on Prescription Drug Policies and Proposals at the Start of the Biden Administration
This brief provides a status update on prescription drug final rules advanced by the Trump Administration in its final months related to Medicare, importation, and […]
Medicare Part D: Do beneficiaries shop for high-value plans?
Medicare Part D covers prescription drugs for largely elderly Americans in the U.S. Those who qualify for both Medicare and Medicaid receive Part D drug […]
Price Increases Continue to Outpace Inflation for Many Medicare Part D Drugs
As context for understanding the rationale for efforts to limit drug price increases, this analysis compares changes in list prices for drugs covered by Medicare […]
Who Didn’t Get a Second Shingrix Shot? Implications for Multidose COVID-19 Vaccines
As the U.S. prepares for nationwide distribution of vaccines to combat COVID-19, some are asking whether people who get the first of two doses will […]
Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond
Medicare provides significant health and financial protections to more than 60 million Americans, but there are gaps in coverage and high cost-sharing requirements that can […]
Medicare Advantage 2021 Spotlight: First Look
For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade, and can […]
Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2021
This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2021, with a focus on stand-alone drug plans. […]
More Than Half of All People on Medicare Do Not Compare Their Coverage Options Annually
This analysis shows that more than half of Medicare beneficiaries do not compare coverage options annually during the open enrollment period, despite the fact that […]
Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment
What You Should Know: – Walmart announced it will begin selling Medicare insurance plans during this year’s annual enrollment period, Oct. 15 through Dec. 7. […]
What’s the Latest on Prescription Drug Proposals from the Trump Administration, Congress, and the Biden Campaign?
This slideshow explains the similarities and differences among major proposals to lower prescription drug costs introduced by the Trump Administration, members of Congress, and the […]
