For the analysis, researchers used data from the Medicare Plan Finder website last November and December to examine annual 2019 out-of-pocket costs for 30 specialty-tier drugs for cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis. They looked at Medicare Part D plans that cover the drug, based on coverage in stand-alone prescription drug plans and costs at a pharmacy in ZIP code 21201 in Baltimore, Md.
That ZIP code approximates prescription drug plan costs nationally because 24 of the 25 Medicare Part D prescription drug plans in that ZIP code are offered nationally or near nationally. Researchers said prescription drug plans also typically use the same formulary and the same specialty-tier coinsurance rate nationally, making the analysis applicable to a majority of U.S. Medicare Part D prescription drug plan enrollees.
While researchers looked at 30 specialty-tier drugs, two of them, Gleevec and Viekira Pak, are not covered by any plan in 2019.
Here is the median annual out-of-pocket cost for the drugs, based on the foundation’s analysis:
Cancer
1. Zytiga – $8,181
2. Erleada – $8,586
3. Venclexta – $8,712
4. Nerlynx – $8,842
5. Imatinib mesylate – $8,983
6. Verzenio – $9,164
7. Calquence – $10,175
8. Rubraca – $10,386
9. Alunbrig – $11,014
10. Zejula – $11,625
11. Rydapt – $11,830
12. Kisqali – $12,145
13. Revlimid – $14,461
14. Idhifa – $16,551
15. Gleevec – N/A
Hepatitis C
16. Zepatier – $2,622
17. Harvoni – $6,338
18. Mavyret – $3,520
19. Epclusa – $5,283
20. Vosevi – $5,306
21. Sovaldi – $5,633
22. Viekira Pak – N/A
Rheumatoid arthritis or multiple sclerosis
23. Kevzara – $4,372
24. Orencia – $5,207
25. Enbrel – $5,465
26. Humira – $5,471
27. Avonex – $6,507
28. Tecfidera – $6,595
29. Copaxone – $6,672
30. Glatiramer acetate – $7,409
Access the full analysis findings here.
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