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Advocacy
10 PRESCRIPTION DRUGS THAT MEDICARE SPENDS THE MOST ON
BLOOD THINNERS, DIABETES TREATMENTS DOMINATE THE LATEST LIST OF COSTLIEST PART D
MEDICATIONS
--------------------------------------------------------------------------------
By
Dena Bunis,
AARP
En español
July 13, 2023
Kristoffer Tripplaar/Alamy
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While Medicare Part D’s prescription drug program paid for more than 3,500
different medications in 2021, the 10 top-selling Rx drugs accounted for nearly
one-quarter of the $216 billion in total Part D spending that year, according to
a new analysis by the nonpartisan KFF.
“Our analysis shows that Medicare Part D spending is highly concentrated among a
small share of covered brand-name drugs, and that increases in gross spending on
the 10 top-selling drugs have contributed to a substantial increase in overall
Medicare drug spending in recent years,” the report from KFF (formerly the
Kaiser Family Foundation) says. The top 100 Part D drugs paid for by Medicare
accounted for 61 percent of all Part D spending in 2021, the latest year for
which data is available.
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The KFF analysis points out how much spending on these most expensive
medications has increased. For example, total Part D spending on the blood
thinner Eliquis increased two and a half times from $5 billion in 2018 to $12.6
billion in 2021. Spending for the diabetes drug Trulicity more than tripled from
$1.4 billion in 2018 to $4.7 billion in 2021. The number of Medicare enrollees
taking these drugs did not increase as much as Medicare spending on the
medication did, KFF data shows.
Of the $216 billion Medicare spent on prescription drugs in 2021, $48 billion
went toward the top 10 selling medications. Half of those brand-name drugs treat
diabetes, two are blood thinners, two treat cancer and one treats rheumatoid
arthritis. Here’s the full list:
10 COSTLIEST MEDICARE PART D PRESCRIPTION DRUGS
* Eliquis, a blood thinner, $12.6 billion
* Revlimid, treats cancer, $5.9 billion
* Xarelto, a blood thinner, $5.2 billion
* Trulicity, treats diabetes, $4.7 billion
* Januvia, treats diabetes, $4.1 billion
* Jardiance, treats diabetes, $3.7 billion
* Imbruvica, treats cancer, $3.2 billion
* Humira (CF) Pen, treats rheumatoid arthritis, $2.9 billion
* Lantus Solostar, treats diabetes, $2.8 billion
* Ozempic, treats diabetes, $2.6 billion
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The KFF report comes as the Centers for Medicare & Medicaid Services (CMS) is in
the process of deciding which will be the first 10 prescription drugs subject to
price negotiations with manufacturers. A 2022 law that included a number of
prescription drug reforms heavily supported by AARP will, for the first time,
allow Medicare to negotiate the price of medications with drugmakers.
The negotiated prices of the first 10 drugs, which have not yet been publicly
identified, will take effect in 2026. Each subsequent year, more medications
will be subject to negotiation.
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The law includes a $35 copay cap on Medicare-covered insulin, and in 2025
out-of-pocket spending on Part D medications will be capped at $2,000.
Drugmakers that raise their prices higher than the rate of inflation are subject
to penalties, and vaccines approved for adults by the Centers for Disease
Control and Prevention (CDC) are free to Part D enrollees.
In September, CMS is scheduled to release the names of the first 10 drugs that
will be subject to negotiation. The agency will take several factors into
account in deciding which medications will be the first whose prices are to be
negotiated. The 10 drugs will be selected from the 50 medications with the
highest Part D expenditures that also are brand-name drugs without generic
equivalents and that have been on the market for at least seven years (or 11
years if they are labeled as biologics).
%{postComment}%
Dena Bunis covers Medicare, health care, health policy and Congress. She also
writes the Medicare Made Easy column for the AARP Bulletin. An award-winning
journalist, Bunis spent decades working for metropolitan daily newspapers,
including as Washington bureau chief for The Orange County Register and as a
health policy and workplace writer for Newsday.
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MEMBERS ONLY
Travel
Dolce® by Wyndham
10% off the best available rate
learn more
See more Travel offers >
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retirement
AARP Social Security Resource Center
Answers to top questions about Social Security retirement benefits
learn more
See more retirement offers >
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MEMBERS ONLY
AARP MEMBERSHIP
Join or Renew Today
Save 25% when you sign up for automatic renewal
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234
*
*
*
*
* MEMBERS ONLY
Health & Wellness
Walgreens
Exclusive Walgreens Cash rewards for members
learn more
See more Health & Wellness offers >
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* MEMBERS ONLY
Travel
Dolce® by Wyndham
10% off the best available rate
learn more
See more Travel offers >
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* retirement
AARP Social Security Resource Center
Answers to top questions about Social Security retirement benefits
learn more
See more retirement offers >
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* MEMBERS ONLY
Health & Wellness
AARP® Dental Insurance Plan administered by Delta Dental Insurance Company
Dental insurance plans for members and their families
learn more
See more Health & Wellness offers >
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