Download At Three Years, Opinion On ACA Remains Divided

Web Event:
Rx Drugs and the U.S. Health System –
A Conversation about Medicare Prescription
Drug Costs
Presented by the Kaiser Family Foundation
Wednesday, September 7, 2016
12:00 p.m. ET to 1:00 p.m. ET
Total U.S. prescription drug spending, in $ billions:
$564
Medicare
Actual Projected
Medicaid
Out of pocket
Other payers
Private health insurance
$495
$464
$328
$205
$236 $241
21%
18%
20%
9%
8%
25%
23%
22%
21%
19%
5%
5%
5%
5%
5%
2%
18%
50%
46%
45%
8%
45%
8%
46%
23%
8%
24%
8%
18%
18%
5%
5%
46%
45%
26%
8%
28%
8%
17%
16%
5%
4%
44%
43%
9%
9%
15%
4%
43%
9%
15%
14%
4%
4%
44%
33%
33%
31%
29%
22%
33%
$385
9%
32%
30%
29%
$265
$253 $253 $259 $259
34%
$409
$343
$298
Part D begins!
34%
$435
WE ARE HERE
$364
$224
$528
43%
9%
14%
4%
43%
9%
31%
9%
13%
4%
43%
9%
13%
4%
42%
9%
13%
4%
42%
9%
13%
4%
42%
9%
13%
4%
42%
12%
4%
41%
12%
4%
41%
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024
NOTE: Medicaid prescription drug spending accounts for rebates.
SOURCE: Kaiser Family Foundation analysis of CMS National Health Expenditure Data for Historical (CY2005-2014) and Projected
(CY2015-2024) Retail Prescription Drug Expenditures, 2013-2024.
Projected average annual growth in Medicare per beneficiary
spending for Parts A, B, and D between 2015-2025
5.8%
4.6%
3.2%
Part A
Part B
Part D
Average Medicare per beneficiary spending:
2015
2025
$5,019
$6,901
SOURCE: 2016 Medicare Trustees Report (Table V.D1).
$5,522
$8,642
$2,203
$3,861
Per Capita Part D benefit spending growth rates
(average annual growth)
6.0%
2.5%
Actual
2006-2015
Projected
2015-2025
SOURCE: Kaiser Family Foundation analysis of data from 2016 Medicare Trustees Report (Table III.D4).
Hepatitis C
43%
57%
$6,516
Sovaldi
42%
58%
$6,608
Harvoni
39%
Cancer
Rheumatoid
Arthritis
Multiple
Sclerosis
Viekira Pak
$5,979
53%
Tecfidera
51%
49%
Copaxone
49%
51%
65%
47%
35%
$6,235
$6,448
$4,413
Humira
65%
35%
$4,864
Enbrel
66%
34%
$4,872
Zytiga
38%
Gleevec
33%
Revlimid
24%
$0
$2,000
Up to catastrophic coverage phase
In catastrophic coverage phase
$7,153
61%
Avonex
Orencia
Median on-formulary out-ofpocket costs in 2016:
$7,227
62%
$8,503
67%
$11,538
76%
$4,000
$6,000
$8,000
$10,000
$12,000
NOTE: Analysis includes 20 national and near-national stand-alone prescription drug plans in Baltimore, MD (zip code 21201) and
reflects pricing at a Rite Aid pharmacy in this zip code.
SOURCE: Georgetown/Kaiser Family Foundation analysis of 2016 Medicare Plan Finder data.
$14,000
Percent who say they favor each of the following:
Requiring drug companies to release
information to the public on how they set their
drug prices
86%
Allowing the federal government to negotiate
with drug companies to get a lower price on
medications for people on Medicare
83%
Limiting the amount drug companies can
charge for high-cost drugs for illnesses like
hepatitis or cancer
76%
Allowing Americans to buy prescription drugs
imported from Canada
Encouraging people to buy lower cost drugs by
requiring them to pay a higher share if they
choose a similar, higher cost drug
NOTE: Items asked of half sample.
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted August 6-11, 2015).
72%
48%
Past and projected Medicare Part D premiums and deductibles:
$900
$811
$770
$800
$700
$846
$730
Annual Part D premium
$658
$694
$618
WE ARE HERE $566
$600
$487
$500
$400
$383 $388 $373 $374 $389
$398 $409
$485
$400 $410
$300
$310 $310 $320 $325 $310 $320
$520
$550
$580
$610
$645
$445
$360
Annual Part D deductible
$200
$100
$0
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
SOURCE: 2016 Medicare Trustees Report (Table V.E2).
Kaiser Family Foundation Resources
10 Essential Facts About Medicare and Prescription Drug Spending
http://kff.org/infographic/10-essential-facts-about-medicare-and-prescription-drugspending
It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016
http://kff.org/medicare/issue-brief/it-pays-to-shop-variation-in-out-of-pocket-costs-formedicare-part-d-enrollees-in-2016
Fact Sheet: Medicare Part D Prescription Drug Benefit
http://kff.org/medicare/fact-sheet/the-medicare-prescription-drug-benefit-fact-sheet
Medicare Part D in 2016 and Trends over Time
Coming Soon!
Additional Resources on Health Costs and Medicare
http://kff.org/health-costs
http://kff.org/medicare