Medicare Safeguard Leaves Taxpayers Pouring Billions Into Pharma’s Pockets
Medicare's catastrophic coverage was originally designed to protect seniors with multiple chronic conditions from the cumulatively high costs of taking many different pills, with the government paying 80 percent of the cost of drugs above a catastrophic threshold. But pricey drugs are stressing the system to its limits.
The Associated Press:
Pricey Drugs Overwhelm Medicare Safeguard
A safeguard for Medicare beneficiaries has become a way for drugmakers to get paid billions of dollars for pricey medications at taxpayer expense, government numbers show. The cost of Medicare's "catastrophic" prescription coverage jumped by 85 percent in three years, from $27.7 billion in 2013 to $51.3 billion in 2015, according to the program's number-crunching Office of the Actuary. Out of some 2,750 drugs covered by Medicare's Part D benefit, two pills for hepatitis C infection — Harvoni and Sovaldi — accounted for nearly $7.5 billion in catastrophic drug costs in 2015. (Alonso-Zaldivar, 7/25)
The Associated Press:
What Are The Top 20 Priciest Medicare Prescription Drugs?
A look at Medicare's top 20 priciest prescription drugs in 2015, ranked by their cost above the program's "catastrophic" coverage threshold. Medicare's catastrophic protection kicks in after a beneficiary has spent a given amount of their own money, $4,850 this year. The beneficiary pays only 5 percent, while their insurer pays 15 percent, and taxpayers cover 80 percent. Catastrophic spending is a large and growing share of total costs, threatening to make Medicare's popular prescription plan financially unsustainable. (7/25)
