Jul 13, 2023 - Health

10 drugs drove a big share of Medicare spending in 2021

Illustration: Gabriella Turrisi/Axios

Ten prescription drugs accounted for nearly one-quarter of gross Medicare drug spending in 2021 — and accounted for more than half of the increase in Part D drug spending from 2018 to 2021, according to a new KFF analysis.

Why it matters: The findings underscore the potential impact of negotiating prices for a limited number of big-ticket drugs under the Inflation Reduction Act.

What they found: A comparatively small number of drugs accounted for an outsized share of the $216 billion in total gross Part D drug spending in 2021.

  • The 10 top-sellers consumed 22% of the total, KFF said. Between 2018 and 2021, aggregate gross spending on the 10 increased from $22 billion to nearly $48 billion.
  • Bristol Myers Squibb's blood thinner Eliquis topped the list, accounting for a quarter of gross spending on Part D drugs in 2021, or $12.6 billion.
  • Medicare spent more than $5 billion each on the No. 2 and 3 drugs: Revlimid, a multiple myeloma treatment also made by Bristol Myers Squibb, and Janssen's blood thinner Xarelto.
  • Spending on Novo Nordisk's Ozempic totaled $2.6 billion in 2021, even though Medicare only covers it as a diabetes drug and doesn't pay when it's prescribed for weight loss.
  • The list also includes Imbruvica, a cancer treatment from Pharmacyclics ($3.2 billion), and Abbvie's Humira Citrate-free pen for rheumatoid arthritis ($2.9 billion).

Catch up quick: Congressional scorekeepers project the negotiations could yield nearly $100 billion in savings through 2031.

  • The government hasn't yet identified which 10 Part D drugs will be subject to price negotiations for 2026, and will weigh updated spending figures and other factors.
  • Some of the drugs on KFF's list won't be eligible because of when they were approved or due to the fact they have generic equivalents.
  • The pharmaceutical industry has filed multiple lawsuits challenging the negotiations, increasing the odds that the implementation of the law will be delayed. The U.S. Chamber of Commerce on Wednesday filed for a preliminary injunction to halt the process.
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