Why are Medicare Part D enrollees paying thousands for specialty drugs?

Medicare is not providing adequate cost savings for the millions of Americans who take specialty medications, as many of them are spending upwards of $10,000 annually on these prescriptions, according to a June 2 report from pharmacy discount service GoodRx.

GoodRx examined the prices for 20 common specialty medications, finding that Medicare Part D enrollees had to pay more than $3,200 in 2021 for each of the drugs on that list. Revlimid and Ibrance were the most expensive drugs on the list, with Medicare Part D enrollees having to pay an annual price of $17,142 and $13,865, respectively.

There are several factors that affect the amount Medicare Part D enrollees pay for their specialty medications, including the Medicare plan a patient selects, the distinct phase of their plan and drugs' list prices.

Different plans offer very different cost savings for specialty medications, so patients could benefit from shopping around. For example, Revlimid's price varies from $20,013 to $2,818 across different Medicare Part D plans. Except for one, all of the 20 drugs had a difference of at least $2,000 between their maximum and minimum annual out-of-pocket costs across plans.

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