New Medicare Drug Data Reveals Costs & New Protections скачать в хорошем качестве

New Medicare Drug Data Reveals Costs & New Protections

New Medicare drug data reveals costs & new protections: In this video, FinStream's Bob Powell interviews Medicare expert Marcia Mantell about the federal government’s latest release of Medicare prescription drug spending data whiich offers a rare, unfiltered look at where billions of dollars are going — and why recent policy changes matter more than ever for retirees. The data, released by the Centers for Medicare & Medicaid Services, include an annual snapshot for 2024 and a quarterly update for early 2025. Together, they track spending across Medicare Part B, which covers physician-administered injectable drugs, and Part D, which covers retail and mail-order prescriptions. For consumers, advisers and policymakers, the numbers confirm two realities at once: prescription drugs are enormously expensive at the system level, and recent reforms have dramatically reduced out-of-pocket risk for individuals. Part B drugs: Few patients, massive spending Part B drugs tend to serve fewer people but carry enormous price tags. These are injectable therapies administered in doctors’ offices or outpatient clinics, often for cancer or complex chronic conditions. In 2024, the highest-spending Part B drug was Keytruda, a cancer therapy, with roughly $6 billion in total spending. The second-highest was Darzalex Faspro, another cancer drug, at about $2.5 billion. While CMS highlights the top 10 drugs in its summary charts, the full Part B dataset runs more than 3,000 rows deep, reflecting the breadth of available therapies and manufacturers. The data do not explain pricing mechanics, but they do illustrate just how quickly costs escalate when advanced treatments are involved. Part D drugs: Where most beneficiaries feel it Part D tells a different story. These are the drugs most Medicare beneficiaries recognize — blood thinners, diabetes medications and cholesterol treatments. The 2024 Part D dataset contains nearly 27,400 rows, reflecting multiple manufacturers and reporting periods. At the top of the list sits Eliquis, a blood thinner used by about 4.4 million people, with total annual spending of $20.8 billion. Other high-spending drugs include Ozempic, Jardiance, Mounjaro, Xarelto and Trulicity. These medications are widely used, often essential, and in many cases have limited alternatives. The scale matters. Many beneficiaries are not on just one drug but several at once. Research consistently shows that the average Medicare beneficiary takes three to four prescriptions, most of them generics. The Part D cap changes the math One of the most important takeaways from the data has little to do with totals and everything to do with protection. Under the Inflation Reduction Act, Medicare now caps annual Part D out-of-pocket spending. In 2026, that cap is $2,100. Consider Dupixent, a drug used to treat asthma, eczema and other inflammatory conditions. In 2024, total spending was about $1.8 billion for roughly 65,000 people, averaging nearly $28,000 per person per year. Before the cap, patients could face tens of thousands of dollars in annual costs. Now, a beneficiary using a preferred pharmacy pays no more than $2,100, regardless of the drug’s total price. That shift fundamentally changes financial risk for retirees, particularly those managing chronic or complex conditions. What price negotiations will — and won’t — do The federal government has also begun negotiating prices for a growing list of high-cost drugs. Those negotiations are expected to reduce overall Medicare spending, but they are unlikely to lower individual out-of-pocket costs further, at least in the short term. For beneficiaries, the cap already limits exposure. For the system, lower prices could help slow premium increases and reduce pressure across Medicare Parts B and D. That matters as health care costs continue to rise. Part B premiums increased nearly 10 percent year over year, and Part D premiums remain highly variable, with some plans doubling in price. Why consumers should look at the data CMS makes both datasets publicly available and searchable. Beneficiaries can look up their own medications, see how widely they are used and understand their role in overall Medicare spending. The data will not answer every pricing question. But they do provide transparency, context and a clearer sense of how policy, coverage and cost intersect in retirement. Key takeaways Prescription drug spending in Medicare runs into the tens of billions, even for a handful of widely used drugs. Most beneficiaries take multiple prescriptions, making system-wide costs large even when individual copays are modest. The Part D out-of-pocket cap dramatically reduces financial risk, especially for high-cost specialty drugs. Price negotiations may help Medicare’s finances, even if individual spending is already capped. Consumers can and should explore CMS drug data to better understand their coverage and costs.