Medicare Plans - Drug Trend Report


Affordable pharmacy care for America’s seniors

For more than a decade, the Medicare Part D benefit has provided America’s seniors with affordable access to prescription medications at a sustainable rate. Since its beginnings as a discount card program, Part D has cost the government less than originally predicted.

Part D plans have effectively kept drug spending increases in check for this population – a trend that continued in 2016 with just a 4.1% increase in year-over-year prescription drug spending. Interestingly, a third of plans had negative trend and more than half show trend below 4.1%.

However, high per member per year (PMPY) on prescription drugs for Medicare beneficiaries in 2016 demonstrates the challenges of managing prescription costs for an older and sicker population. While competitive forces do drive down costs, there are requirements that limit the tools Part D plans can use to even more effectively drive down costs.

We believe plans with greater flexibility for the use of PBM tools can help position Part D plans further manage drug trend in this population. With a few modifications that will allow Part D providers to fully leverage programs and solutions proven to lower drug spending, Medicare Part D plan can continue on this successful path, providing seniors with high quality, affordable prescription drug coverage.

Read our full report to learn more about Medicare prescription drug spending in 2016.

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