Total reimbursement for brand-name prescription drugs in Medicare Part D increased 77% between 2011 and 2015, nearly six times faster than inflation, despite a 17% decrease in the number of prescriptions, according to a report released today by the Department of Health and Human Services’ Office of Inspector General. The share of beneficiaries with at least $2,000 in annual out-of-pocket costs for brand-name drugs nearly doubled over the five-year period to 7.3%. “Generally, plan sponsors base their reimbursement amounts on the prices that manufacturers set for their drugs,” OIG said. “Therefore, increasing manufacturer prices for brand-name drugs may result in increasing costs for Medicare and its beneficiaries, especially those beneficiaries who need access to expensive maintenance drugs.”

Related News Articles

Headline
The median net launch price for 154 new drugs increased 51% between 2022 and 2024, after accounting for inflation and discounts, according to a report released…
Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and…
Headline
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans…
Headline
Medicare open enrollment for 2026 began Oct. 15 and runs through Dec. 7. During the annual enrollment period, Medicare-eligible individuals can check their…
Headline
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…