Prescription drug prices are a top concern for policymakers and the public, but little data is available on prescription drug prices or other costs that contribute to premiums for commercial drug coverage.
Drug Pricing
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Medicare Coverage of Anti-Obesity Medications
In November 2024, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Program; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly proposed rule.
ASPE Issue Brief
Medicare Part D Enrollees Reaching the Out-of-Pocket Limit by June 2024
The Inflation Reduction Act established a limit on out-of-pocket spending (“the 2024 cap”) for enrollees with very high prescription drug spending in Medicare Part D, for the first time in the history of the program.
ASPE Issue Brief
Medicare Drug Price Negotiation Program: Medicare Prices Negotiated for 2026 Compared to List and U.S. Market Prices
The Inflation Reduction Act (IRA) makes improvements to Medicare to increase accessibility and affordability of prescription drugs for Medicare enrollees, reduce the rate of growth in Medicare drug spending, and improve the financial sustainability of the Medicare program.
ASPE Issue Brief
Impacts of a Nonprofit Membership-Based Pharmaceutical Company on Volume of Drugs Sold and Drug Prices: A Case Study
We report findings of a case study of Civica Rx, a U.S. nonprofit pharmaceutical company whose model is based on long-term hospital membership agreements with minimum volume commitments and buffer stock requirements.Related Products:
Fact Sheet
State Fact Sheets: Impacts of the IRA and ACA on Lowering Health Care Costs, 2024
These Fact Sheets highlight health care cost savings achieved under the Inflation Reduction Act (IRA) and the Affordable Care Act (ACA) for each of the fifty states and the District of Columbia. Enrollee savings on Medicare Part D out-of-pocket costs, insulin, vaccines, and Marketplace premiums are presented.
Fact Sheet
Inflation Reduction Act Research Series: Projected Impacts for Women Enrolled in Medicare
The Inflation Reduction Act (IRA) is helping people with Medicare, including nearly 30 million women enrolled in Part D. Our review shows that, in 2020, about 733,000 women enrolled in Part D and B would have benefited from the IRA’s $35 insulin cap and, in 2021, about 2 million women would not have had any out-of-pocket costs for recommended adult vaccines covered by Part D.
ASPE Issue Brief
Generic Drug Utilization and Spending Among Medicare Part D Enrollees in 2022
In 2022, 43.3 million Medicare Part D enrollees (82 percent) filled 1.1 billion prescriptions for generic prescription drugs. While most enrollees filled at least one prescription for $2 or less, most (54 percent) paid more than $2 for at least one generic drug. Over 6 million enrollees filled at least one prescription for over $20.
Fact Sheet
Inflation Reduction Act Research Series: Projected Impacts for Rural Medicare Enrollees
The Inflation Reduction Act (IRA) is helping people with Medicare, including over 8 million Part D enrollees who reside in rural areas. This fact sheet outlines the potential impacts of the IRA’s key drug-related provisions for rural Medicare enrollees.
ASPE Issue Brief
Medicare Enrollees and the Part D Drug Benefit: Improving Financial Protection through the Low-Income Subsidy
The Inflation Reduction Act’s (IRA) expanded financial assistance in Medicare’s Low-Income Subsidy (LIS) Program would have benefited nearly 461,000 Partial LIS enrollees had the provision been in effect in 2020. An additional 2.9 million Part D enrollees who were eligible but not enrolled in LIS would also have benefited from the program.