Prescription Drug Benefits

The Inflation Reduction Act (IRA) is helping people with Medicare afford their medications, including the 2.1 million Asian, 5.8 million Black, and 5.3 million Latino Part D enrollees. These fact sheets review existing research to present the projected impacts of key IRA Medicare drug-related provisions for these populations.

The Inflation Reduction Act (IRA) authorizes the Secretary of the Department of Health and Human Services (HHS) to negotiate prices directly with participating manufacturers for selected drugs that are high expenditure, single source drugs without generic or biosimilar competition.

Introduction

The Inflation Reduction Act (IRA) will make key changes to improve drug affordability for people who have Medicare.

The U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE) released new research on spending and utilization trends of Medicare Part B drugs, drugs administered in physicians' office or hospital outpatient departments rather than being purchased at the pharmacy counter or by mail order.

Effective January 1, 2023, out-of-pocket costs for insulin are capped at $35 per monthly prescription among Medicare Part D enrollees under the Inflation Reduction Act (IRA). A similar cap takes effect in Medicare Part B on July 1, 2023.

This Report to Congress examines the critical role that insulin plays in the treatment of diabetes, reviews evidence on how insulin affordability affects adherence to insulin treatment and affects downstream health consequences, and describes policy efforts to improve the affordability of insulin.

High prescription drug costs are a leading concern among Americans. Americans pay higher prices for prescription drugs than any other country in the world, with prescription drug prices in the U.S. more than 2.5 times as high as those in other similar high-income nations.

Prescription drug price increases create affordability challenges for patients and for the government. This report tracks drug price changes from 2016-2022. There were 1,216 products whose price increases during the twelve-month period from July 2021 to July 2022 exceeded the inflation rate of 8.5 percent for that time period. The average price increase for these drugs was 31.6 percent.

Key FindingsPolicy discussion surrounding U.S. prescription drug prices focuses on whether prices in the United States are too high or appropriate relative to the benefits that they offer to patients.