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64 Medicare Prescription Drugs That Are Getting More Affordable

The coinsurance rates for certain Part B medications are being lowered temporarily. Here’s why


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AARP (Source: Getty Images (2))

Some people with Medicare could end up spending less money on potentially lifesaving medications in the beginning of the new year.

The U.S. Department of Health and Human Services (HHS) announced that 64 drugs available through Medicare Part B will have a lower coinsurance rate between Jan. 1 and March 31, 2025, since the prices set by their manufacturers have risen faster than the rate of inflation.

Drugs that fall under Part B are typically administered in a doctor’s office or hospital and can include cancer treatments, Alzheimer’s treatments and injectable osteoporosis medications.

Under a provision in the AARP-backed prescription drug law passed in 2022, the coinsurance rates for these 64 medications will be 20 percent of what the price would have been if it increased with inflation, which will be less than what the beneficiary would pay otherwise. Drugmakers will also face penalties for the price hikes in the form of a rebate to Medicare, and these funds will be used to help ensure the sustainability of the national health insurance program that provides coverage to more than 67 million Americans who are older or have a disability.   

Some could see significant savings

More than 853,000 people with Medicare use the 64 selected drugs annually to treat conditions such as cancer, osteoporosis and substannce use disorder. According to HHS, some people with Medicare taking these medications could see savings in the last quarter of the year that range from $1 a day to more than $10,800 a day.

How much each person pays for their medications varies, depending on whether they have additional insurance that covers or reduces Part B’s 20 percent coinsurance. The list price for some of these drugs is hundreds of thousands of dollars per treatment.

“By discouraging drug companies from raising their prices faster than inflation, we are keeping prices affordable for the people with Medicare who rely on these drugs to live healthier lives,” HHS Secretary Xavier Becerra said in a statement.

The Medicare Prescription Drug Inflation Rebate Program is just one provision under the 2022 law that’s aimed at lowering drug prices and related out-of-pocket costs. The law also gives Medicare the power to negotiate lower prices for certain prescription medications. The first batch of negotiations included 10 common and costly medications, and when the lower prices take effect in 2026 they will save people with Medicare prescription drug plans a collective $1.5 billion in out-of-pocket expenses, health officials project.

Another key provision in the law caps annual out-of-pocket prescription drug expenses at $2,000 starting Jan. 1. The new limit is expected to benefit nearly 3.2 million older Americans with a Medicare prescription drug plan in 2025, AARP research found. That number will swell to more than 4 million in 2029.

“The Inflation Reduction Act is lowering prescription drug costs so that people can access the medications they need,” Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure said in a news release. “As we head into 2025, people with Medicare will feel substantial relief from high drug prices." 

64 drugs subject to coinsurance rate adjustments ​

Adjustments will take effect Jan. 1 to March 31, 2025 

  1. Abecma
  2. Adcetris
  3. Akynzeo Capsule
  4. Atgam
  5. Aveed
  6. Berinert
  7. Bicillin C-R
  8. Bicillin L-A
  9. Blincyto
  10. Breyanzi
  11. Brixadi (Monthly Dosing)
  12. Brixadi (Weekly Dosing)
  13. Carvykti
  14. Chirhostim
  15. Cresemba
  16. Crysvita
  17. Cyclophosphamide (Dr. Reddy)
  18. Digifab
  19. Elfabrio
  20. Envarsus XR
  21. Evenity
  22. Folotyn
  23. Fosaprepitant
  24. Fragmin
  25. Fyarro
  26. Gemcitabine (Accord)
  27. Hizentra
  28. Imlygic
  29. Ixempra
  30. Kepivance
  31. Krystexxa
  32. Kymriah
  33. Kyprolis
  34. Leukine
  35. Lupron Depot-Ped
  36. Meropenem (B. Braun)
  37. Minocin
  38. Nexterone (Baxter)
  39. Nipent
  40. Nplate
  41. Oncaspar
  42. Padcev
  43. Panhematin
  44. Prolia
  45. Qalsody
  46. Rezzayo
  47. Rybrevant
  48. Rylaze
  49. Signifor Lar
  50. Sotalol (Altathera)
  51. Sylvant
  52. Talvey
  53. Tecartus
  54. Tecvayli
  55. Tigan
  56. Tivdak
  57. Tnkase
  58. Vectibix
  59. Vyepti
  60. Vyxeos
  61. Xiaflex
  62. Yescarta
  63. Zerbaxa
  64. Zoladex

Editor’s note: This story has been updated to reflect new information.

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