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Just Released
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One Million Medicare Part D Enrollees
Had Out-of-Pocket Drug Costs Above the Catastrophic Threshold in 2017, with
Average Costs of More Than $3,200 Per Person
One million Medicare beneficiaries had
out-of-pocket prescription drug spending above the Part D catastrophic
threshold in 2017, with such spending averaging more than $3,200 per person,
according to a new KFF analysis.
Since 2007, the number of Part D enrollees without
low-income subsidies who have spending above the threshold has more than doubled,
topping one million enrollees per year from 2015 to 2017. Treatments for
autoimmune diseases, hepatitis C, and certain types of cancer were among the
highest-cost medications for these one million enrollees in 2017, with
out-of-pocket spending for a single drug averaging over $5,000 per person,
and sometimes much more.
The experiences of Medicare Part D enrollees with
high spending on medications has caught the attention of policymakers in
Washington, among whom there is growing and bipartisan interest in placing a
cap on annual out-of-pocket spending under Part D. The standard Part D
benefit has a catastrophic threshold above which enrollees pay up to 5
percent of their total drug costs out-of-pocket.
While Part D has helped make drugs more affordable
for people with Medicare, the lack of a hard spending cap can expose enrollees
to significant costs, unless they qualify for low-income subsidies. Although
people with out-of-pocket costs above the catastrophic threshold accounted
for only two percent of Part D enrollees in 2017, their costs accounted for
20 percent of the total $16 billion spent out-of-pocket by beneficiaries that
year.
For the full analysis as well as other KFF research on prescription drugs and their costs, visit kff.org.
Filling the need for trusted information on
national health issues, the Kaiser Family Foundation is a
nonprofit organization based in San Francisco, California.
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Monday, June 24, 2019
One Million Medicare Part D Enrollees Had Out-of-Pocket Drug Costs Above the Catastrophic Threshold in 2017
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