Prescription Drugs

The Inflation Reduction Act (IRA) changes the way Medicare pays for prescription drugs. These changes will impact various stakeholders, including Medicare, Medicare enrollees, drug manufacturers, and others.

March-in authority allows the federal government to grant licenses on privately owned patents for inventions developed with federal funding provided certain statutory requirements are met. It was designed to ensure that the benefits of the American taxpayers’ investment in research and development are reasonably accessible to the public.

The Centers for Medicare & Medicaid Services (CMS) Innovation Center is in the process of developing the Medicare $2 Drug List (M2DL) Model. This would allow Part D plan sponsors to offer a standardized list of generic drugs for a copayment of $2 or less for a month’s supply that would not be subject to prior authorization, quantity limits, or other utilization management restrictions.

In this Report, we matched a sample of Part D drugs and biological products that had price changes between January 2011 and October 2023 to FDA’s January 2023 list of drug shortages database. Then we analyzed price changes that occurred before and after the shortage, overall and by select drug characteristics of interest.

In this Report, we matched a sample of Part B drugs and biological products that had price changes between January 2011 and October 2023 with the FDA’s January 2023 list of drug shortages database. Then we analyzed price changes that occurred before and after the shortage, overall and by select drug characteristics of interest.

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.

This study of national retail pharmacy data from 2013 to 2022, found an overall increase in buprenorphine dispensed to women of reproductive age and a marked increase in fills that were prescribed by nurse practitioners/physician assistants.

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.

It is anticipated that extreme weather events due to climate change will increase the prevalence of a number of acute and chronic diseases. As a result, the demand for drugs to prevent or treat those conditions is likely to increase.

This landing page presents the abstract of a paper published in Health Affairs. The full text of the article is available at: https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2023.00837.