Patient cost sharing for prescription drugs: Policy issues

Prescription drug costs continue to grow in the U.S. due to both price hikes for existing drugs and the development of expensive new therapies. In Medicare, these costs now account for $1 out of every $6 in spending . As costs grow, particularly for specialty drugs and novel therapies, patients can face high cost-sharing burdens, and the Medicare benefit places no limit on a patient’s out-of-pocket spending for prescription drugs. Moreover, while increased rebates have often mitigated the growth in net drug prices, many patients still pay cost-sharing based on a percentage of the gross (pre-rebate) drug price.

On Friday, February 16, the USC-Brookings Schaeffer Initiative for Health Policy hosted a conference on the policy issues surrounding patient drug cost sharing. Two panels convened, first to discuss restructuring the Medicare Part D benefit design, and then to debate the effectiveness of mechanisms to reduce cost sharing for commercially insured patients.